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腹股沟疝导致网膜扭转:CT 在鉴别其他临床表现方面的作用——病例报告及文献复习。

Inguinal hernia leading to omental torsion: Role of CT in differentiating from other clinical mimics - a case report and literature review.

机构信息

Department of Radiology, Post Graduate Medical Institute, Ameer-Ud-Din Medical College, Lahore General Hospital, Pakistan.

Department of Radiology, Mayo Hospital, Pakistan.

出版信息

J Radiol Case Rep. 2023 Nov 30;17(11):8-17. doi: 10.3941/jrcr.v17i11.4722. eCollection 2023 Nov.

Abstract

Omental torsion is a very rare cause of acute abdomen. Clinically, it mimics other common pathologies such as acute appendicitis, acute diverticulitis and acute cholecystitis. It is therefore no surprise, that it was rarely diagnosed pre operatively before the advent and easy availability of modern imaging techniques. CT scan, in particular, can diagnose omental torsion with confidence pre operatively. This can make conservative treatment possible in cases of primary omental torsion and guide regarding the appropriate treatment in cases of secondary torsion. We present a case of a young male patient who presented to Emergency department with symptoms of acute abdomen. Clinical and laboratory findings were non-specific for any specific cause of acute abdomen. CT scan, however, showed omental fat stranding with whirlpool sign representing omental torsion which was seen to be secondary to left inguinal hernia. Patient was operated in emergency and necrotic omentum was resected and hernia repaired. Post-operative recovery was uneventful.

摘要

网膜扭转是一种非常罕见的急性腹痛原因。临床上,它模仿其他常见的病理情况,如急性阑尾炎、急性憩室炎和急性胆囊炎。因此,在现代成像技术出现和易于获得之前,术前很少能诊断出这种疾病,这并不奇怪。特别是 CT 扫描可以在术前有信心地诊断网膜扭转。这可以使原发性网膜扭转的保守治疗成为可能,并指导继发性扭转的适当治疗。我们报告了一例年轻男性患者,他因急性腹痛症状就诊于急诊科。临床和实验室检查结果对任何特定原因的急性腹痛均无特异性。然而,CT 扫描显示网膜脂肪绞索,呈漩涡征,代表网膜扭转,继发于左侧腹股沟疝。患者在急诊手术中,切除了坏死的网膜并修复了疝。术后恢复顺利。

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Omental torsion, a rare cause of acute surgical abdomen.大网膜扭转,一种罕见的急性外科腹痛病因。
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Left-sided omental torsion with inguinal hernia.左侧网膜扭转伴腹股沟疝
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本文引用的文献

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Omental torsion; an unusual case of acute abdomen. Case report.网膜扭转;一例罕见的急腹症。病例报告。
Int J Surg Case Rep. 2023 Feb;103:107901. doi: 10.1016/j.ijscr.2023.107901. Epub 2023 Jan 14.
3
Omental infarction found incidentally during metastatic workup: A report of 2 cases.在转移灶检查中偶然发现的网膜梗死:2例报告
Radiol Case Rep. 2023 Jan 5;18(3):991-995. doi: 10.1016/j.radcr.2022.11.072. eCollection 2023 Mar.
8
Watchful Waiting for Inguinal Hernia.腹股沟疝的观察等待
Adv Surg. 2019 Sep;53:293-303. doi: 10.1016/j.yasu.2019.04.014. Epub 2019 May 15.

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