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小儿腹腔镜腹股沟斜疝修补术中偶然发现的里脱疝

Littre's Hernia Incidentally Found During Laparoscopic Indirect Inguinal Hernia Repair in a Child.

作者信息

Tsukada Ryo, Iwasaki Shun, Ibuka Souji, Saka Ryuta

机构信息

Department of Pediatric Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, JPN.

出版信息

Cureus. 2024 Aug 9;16(8):e66528. doi: 10.7759/cureus.66528. eCollection 2024 Aug.

DOI:10.7759/cureus.66528
PMID:39246986
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11380929/
Abstract

Littre's hernia is a rare type of hernia in which Meckel's diverticulum is found in the hernia sac. While most cases present with incarceration, incidentally discovered cases of Littre's hernia without incarceration are even rarer. A three-month-old boy was referred to our hospital with a three-month history of right inguinal swelling. Although the swelling was reducible, re-prolapse was readily observed. Small bowel obstruction and gastrointestinal bleeding had not been experienced. Laparoscopic herniorrhaphy was planned for right inguinal hernia repair at four months of age during which Littre's hernia was incidentally discovered intraoperatively. Following laparoscopic herniorrhaphy, extracorporeal small bowel resection was performed. The postoperative course was uneventful and the patient was followed up for nine months without symptoms. Laparoscopic herniorrhaphy is a useful surgical technique, as it may facilitate the detection of unexpected complications, which might be overlooked with the inguinal approach.

摘要

里脱疝是一种罕见的疝,疝囊内可发现梅克尔憩室。虽然大多数病例表现为嵌顿,但偶然发现的无嵌顿里脱疝病例更为罕见。一名3个月大的男孩因右侧腹股沟肿胀3个月被转诊至我院。尽管肿胀可回纳,但很容易观察到再次脱出。未出现小肠梗阻和胃肠道出血。计划在4个月大时行腹腔镜疝修补术修复右侧腹股沟疝,术中偶然发现里脱疝。腹腔镜疝修补术后,进行了体外小肠切除术。术后过程顺利,对患者进行了9个月的随访,无任何症状。腹腔镜疝修补术是一种有用的手术技术,因为它可能有助于发现意外的并发症,而腹股沟入路可能会忽略这些并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b37/11380929/a559043b07a6/cureus-0016-00000066528-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b37/11380929/1ec9ba443997/cureus-0016-00000066528-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b37/11380929/a559043b07a6/cureus-0016-00000066528-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b37/11380929/1ec9ba443997/cureus-0016-00000066528-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b37/11380929/a559043b07a6/cureus-0016-00000066528-i02.jpg

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本文引用的文献

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Management of Littre Hernia-Case Report and Systematic Review of Case Reports.里脱疝的治疗——病例报告及病例报告系统评价
J Clin Med. 2023 May 29;12(11):3743. doi: 10.3390/jcm12113743.
2
Incarcerated Littre's Hernia in a Neonate Presenting as Enteroscrotal Fistula.新生儿嵌顿性里脱疝表现为小肠阴囊瘘
J Indian Assoc Pediatr Surg. 2023 Mar-Apr;28(2):164-166. doi: 10.4103/jiaps.jiaps_110_22. Epub 2022 Nov 30.
3
A case report of an asymptomatic necrotic Meckel's diverticulum in an inguinal hernia during elective surgery in a resource limited setting: Littre's hernia.
资源有限环境下择期手术中腹股沟疝内无症状坏死梅克尔憩室的病例报告:里特疝
Int J Surg Case Rep. 2023 Apr;105:108011. doi: 10.1016/j.ijscr.2023.108011. Epub 2023 Mar 22.
4
Litrre's hernia: partially reduced inguinal hernia in a 3-year-old boy.里脱疝:一名3岁男孩的部分还纳性腹股沟疝。
J Surg Case Rep. 2021 Sep 30;2021(9):rjab421. doi: 10.1093/jscr/rjab421. eCollection 2021 Sep.
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Littré's Hernia: A Rare Intraoperative Finding.利特雷疝:一种罕见的术中发现。
Cureus. 2020 Oct 20;12(10):e11065. doi: 10.7759/cureus.11065.
6
Simultaneous Presentation of a Right Littre's Hernia and a Left Amyand's Hernia in a School-Aged Patient.一名学龄期患者同时出现右侧里脱氏疝和左侧艾米安德氏疝
Case Rep Surg. 2019 Jun 10;2019:4217329. doi: 10.1155/2019/4217329. eCollection 2019.
7
Littre hernia in children: A clinical aspect.小儿里脱疝:临床情况
Turk J Gastroenterol. 2019 Jan;30(1):101-104. doi: 10.5152/tjg.2018.18228.
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Systematic review of epidemiology, presentation, and management of Meckel's diverticulum in the 21st century.21世纪梅克尔憩室的流行病学、临床表现及治疗的系统评价
Medicine (Baltimore). 2018 Aug;97(35):e12154. doi: 10.1097/MD.0000000000012154.
9
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J West Afr Coll Surg. 2016 Apr-Jun;6(2):125-130.
10
Littre's hernia in a paediatric patient.小儿患者的里脱疝
Afr J Paediatr Surg. 2014 Oct-Dec;11(4):351-3. doi: 10.4103/0189-6725.143168.