Muta Yuki, Odaka Akio, Inoue Seiichiro, Takeuchi Yuta, Beck Yoshifumi
Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama 3508550, Japan.
J Surg Case Rep. 2023 Sep 5;2023(9):rjad503. doi: 10.1093/jscr/rjad503. eCollection 2023 Sep.
A female newborn weighing 542 g and delivered at 27 weeks gestation presented with bilateral inguinal hernias while in the neonatal intensive care unit. Ultrasonography confirmed herniation of the uterus into the right inguinal hernia without signs of incarceration. Due to the absence of complications, she was discharged and scheduled for follow-up at the outpatient clinic. At 11 months of age, a subsequent ultrasonography showed only omental herniation, with no evidence of uterine prolapse. When she reached 1 year of age, a laparoscopic percutaneous extraperitoneal closure procedure was performed. During the surgery, it was observed that the uterus and fallopian tubes were located near the hernia orifice, but no clear prolapse was detected. The procedure concluded safely with successful high ligation. It has noted that in cases of uterine prolapse hernias, the uterus tends to recede as the child grows, which supports the decision to delay surgery for improved safety.
一名孕27周出生的女婴,体重542克,在新生儿重症监护病房时出现双侧腹股沟疝。超声检查证实子宫疝入右侧腹股沟疝,无嵌顿迹象。由于无并发症,她出院并安排在门诊随访。11个月大时,后续超声检查仅显示网膜疝,无子宫脱垂迹象。1岁时,进行了腹腔镜经皮腹膜外闭合手术。手术中观察到子宫和输卵管位于疝孔附近,但未发现明显脱垂。手术安全完成,高位结扎成功。值得注意的是,在子宫脱垂疝的病例中,随着孩子长大,子宫往往会回缩,这支持了延迟手术以提高安全性的决定。