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经阑尾系膜内疝导致小肠梗阻:一例报告

Internal hernia through mesoappendix causing small bowel obstruction: A case report.

作者信息

Gashey Eneyew Mebratu, Tiruneh Sileshi Genetu, Gelaw Fekadu Wudie, Tebabel Adugna Tasew, Gelaw Litegebew Yitayeh

机构信息

Department of Surgery, GAMBY Medical and Business College, Bahirdar, Ethiopia.

Department of Surgery, GAMBY Medical and Business College, Bahirdar, Ethiopia.

出版信息

Int J Surg Case Rep. 2024 Dec;125:110590. doi: 10.1016/j.ijscr.2024.110590. Epub 2024 Nov 12.

Abstract

INTRODUCTION

Intestinal obstruction is one of causes of acute abdomen leading to laparotomy. Even though there are different causes of small bowel obstruction (SBO), internal hernia is a rare one. Though different types of internal hernias occur, herniation through the mesoappendix is reported only four times in the literature.

CASE PRESENTATION

We describe here such a type of hernia on a 50 yrs old male presented with symptoms and signs of SBO whose cause was diagnosed to be internal hernia through mesoappendix intraoperatively. He was managed with appendectomy and release of the hernia.

CLINICAL DISCUSSION

Intestinal obstruction is a common cause of acute abdominal conditions and can lead to significant mortality if not managed appropriately. Internal hernias account for less than 1 % of intestinal obstruction cases. The cause of trans-mesoappendicular internal hernias remains largely unknown. A congenital defect in the mesoappendix may contribute to the development of these hernias.

CONCLUSION

In patients with acute intestinal obstruction without previous surgery, internal hernia should be considered as a differential diagnosis. Trans-mesoappendicular hernia is extremely rare type of internal hernia.

摘要

引言

肠梗阻是导致剖腹手术的急腹症病因之一。尽管小肠梗阻(SBO)有不同病因,但内疝是一种罕见病因。虽然存在不同类型的内疝,但文献中仅报道过4例经阑尾系膜发生的疝。

病例介绍

我们在此描述一名50岁男性患者,其表现出SBO的症状和体征,术中诊断其病因是经阑尾系膜的内疝。对其进行了阑尾切除术及疝松解术。

临床讨论

肠梗阻是急性腹部疾病的常见病因,若处理不当可导致显著的死亡率。内疝占肠梗阻病例的比例不到1%。经阑尾系膜内疝的病因在很大程度上仍不清楚。阑尾系膜的先天性缺陷可能促使这些疝的发生。

结论

对于既往无手术史的急性肠梗阻患者,应将内疝作为鉴别诊断之一。经阑尾系膜疝是极为罕见的内疝类型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/663c/11605386/fd9b6323152f/gr1.jpg

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