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胸椎椎间盘突出症所致腹部假性疝:病例系列及文献综述

Abdominal pseudohernia caused by thoracic disk herniation: case series and review of the literature.

作者信息

Massé G, Al Khaldi M, Schwenter F, Boudier-Revéret M, Sebajang H

机构信息

Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), 1000 rue St-Denis, Montreal, QC H2X 0C1, Canada.

Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal (CHUM), 1000 rue St-Denis, Montreal, QC H2X 0C1, Canada.

出版信息

J Surg Case Rep. 2025 Jan 23;2025(1):rjae822. doi: 10.1093/jscr/rjae822. eCollection 2025 Jan.

Abstract

Intervertebral thoracic disk herniation (TDH) is a rare occurrence and presents with a wide variety of symptoms. Errors in diagnosis are thought to be frequent due to the variable clinical presentations. We herein present two unusual cases of TDH presenting with abdominal pseudohernias, abdominal pain, and hypoesthesia along the T11-T12 dermatomes due to TDH at the same level. Both patients were managed conservatively, using a combination of analgesics and muscle relaxants. At 10 months of follow-up, the first patient reported complete resolution of abdominal bulge and no residual pain. The second patient reported residual paresthesia of T11-T12 dermatome, with non-limiting back pain and almost complete resolution of abdominal bulge. In conclusion, TDH may present with an abdominal wall bulge mimicking hernia, hypoesthesia, and radicular pain along the affected dermatome. Conservative management can be considered as first-line treatment.

摘要

胸椎间盘突出症(TDH)较为罕见,症状多样。由于临床表现各异,误诊情况较为常见。我们在此报告两例不寻常的TDH病例,均表现为腹部假性疝、腹痛以及因同一水平的TDH导致的T11 - T12皮节感觉减退。两名患者均采用镇痛药和肌肉松弛剂联合的保守治疗方法。随访10个月时,首例患者报告腹部隆起完全消失且无残留疼痛。第二例患者报告T11 - T12皮节有残留感觉异常,背痛不严重,腹部隆起几乎完全消失。总之,TDH可能表现为类似疝的腹壁隆起、感觉减退以及沿受累皮节的神经根性疼痛。保守治疗可作为一线治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11d4/11756312/9129c3f710e4/rjae822f1.jpg

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