Malbul Kiran, Rajbhandari Ashish Prasad
Nepalese Army Institute of Health Sciences College of Medicine, Sanobharyang, Kathmandu, Nepal.
Department of GI and General Surgery, Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, Nepal.
Int J Surg Case Rep. 2024 Jan;114:109206. doi: 10.1016/j.ijscr.2023.109206. Epub 2024 Jan 2.
Femoral hernias following inguinal hernia repairs are an unusual occurrence that presents diagnostic challenges for healthcare providers. Surgical repair of inguinal hernias is generally successful, but complications and recurrence can arise. The coexistence of femoral hernias following inguinal hernia repairs is rare, requiring careful evaluation and management.
A middle-aged patient sought medical attention with complaints of recurrent groin pain and a palpable bulge in the inguinal region. Initial imaging studies, including ultrasonography and contrast-enhanced computed tomography (CT), pointed towards an inguinal hernia, leading to the scheduling of surgical repair. However, during the operation, the surgeon discovered a femoral hernia, highlighting the limitations of imaging techniques in accurately diagnosing these hernia types.
Due to anatomical variations and overlapping signs and symptoms, distinguishing between femoral and inguinal hernias can be challenging. Scar tissue from previous inguinal hernia repairs can further complicate imaging interpretations. Intraoperative exploration becomes crucial to confirm the diagnosis and facilitate proper surgical repair.
The reported case emphasizes the importance of maintaining vigilance in evaluating patients with suspected hernias, particularly those with prior inguinal hernia repairs. Relying solely on imaging studies can lead to misdiagnosis, as illustrated by the discovery of a femoral hernia during surgery. Healthcare providers should be aware of the possibility of femoral hernias and conduct comprehensive evaluations to ensure timely intervention and improve patient outcomes. Further research and awareness are essential to optimize the care of such uncommon clinical scenarios.
腹股沟疝修补术后出现股疝是一种不常见的情况,给医疗服务提供者带来了诊断挑战。腹股沟疝的手术修复通常是成功的,但可能会出现并发症和复发。腹股沟疝修补术后并存股疝的情况很少见,需要仔细评估和处理。
一名中年患者因反复腹股沟疼痛和腹股沟区可触及肿块前来就医。包括超声检查和增强计算机断层扫描(CT)在内的初步影像学检查提示为腹股沟疝,因此安排了手术修复。然而,在手术过程中,外科医生发现了一个股疝,这凸显了影像学技术在准确诊断这些疝类型方面的局限性。
由于解剖变异以及体征和症状重叠,区分股疝和腹股沟疝可能具有挑战性。既往腹股沟疝修补术形成的瘢痕组织会使影像学解读更加复杂。术中探查对于确诊和促进正确的手术修复至关重要。
报告的病例强调了在评估疑似疝患者,尤其是既往有腹股沟疝修补术的患者时保持警惕的重要性。如手术中发现股疝所示,仅依靠影像学检查可能导致误诊。医疗服务提供者应意识到存在股疝的可能性,并进行全面评估,以确保及时干预并改善患者预后。进一步的研究和认识对于优化此类罕见临床情况的治疗至关重要。