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2岁女童因异物导致脐疝梗阻;病例报告

Foreign body causing obstructed umbilical hernia in a 2-year-old girl; A case report.

作者信息

Khalid Rija, Inam Ifrah, Haider Naveed, Abdullah Rabia

机构信息

Akram Medical Complex, Lahore, Pakistan.

Akram Medical Complex, Lahore, Pakistan.

出版信息

Int J Surg Case Rep. 2025 Apr;129:111156. doi: 10.1016/j.ijscr.2025.111156. Epub 2025 Mar 14.

Abstract

INTRODUCTION AND IMPORTANCE

Umbilical hernia (UH), quite prevalent in pediatric population, may rarely present with serious complications like incarceration or viscus organ strangulation. An incarcerated hernia is the one which cannot be reduced back whereas, strangulation results when blood supply to the entrapped tissue is compromised.

CASE PRESENTATION

A 2-year-old female child, with history of reducible umbilical swelling since birth, presented in the emergency department with signs of acute obstruction. Examination favored an irreducible umbilical hernia to be the cause of the patient's clinical condition. Provisional diagnosis was further strengthened by emergency investigations including abdominal ultrasound and x-ray abdomen. Exploration after adequate resuscitation was planned. However, an unusual finding of intestinal perforation due to date seed was found.

DISCUSSION

Entrapment of omentum appears to be the most common cause of obstructed UHs. Incarceration due to foreign body is rarely observed in umbilical hernias. This case highlights the importance of considering unusual etiologies in medical practice.

CONCLUSION

There is relative lack of data regarding management options for obstructed umbilical hernia and this case is an effort to enrich current literature. Parental education plays a pivotal role in dealing with anxiety as well as executing proper management plan.

摘要

引言与重要性

脐疝(UH)在儿科人群中相当普遍,很少会出现诸如嵌顿或脏器绞窄等严重并发症。嵌顿疝是指无法回纳的疝,而绞窄是指被困组织的血液供应受到损害。

病例介绍

一名2岁女童,自出生以来有可复性脐部肿物病史,因急性肠梗阻症状就诊于急诊科。检查倾向于不可复性脐疝是导致该患者临床状况的原因。包括腹部超声和腹部X线在内的急诊检查进一步支持了初步诊断。计划在充分复苏后进行探查。然而,发现了因枣核导致肠穿孔这一不寻常的情况。

讨论

大网膜嵌顿似乎是梗阻性脐疝最常见的原因。脐疝中因异物导致嵌顿的情况很少见。该病例强调了在医疗实践中考虑不寻常病因的重要性。

结论

关于梗阻性脐疝的治疗选择,相对缺乏数据,本病例旨在丰富当前文献。家长教育在应对焦虑以及执行适当的管理计划方面起着关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba1e/11979417/bd5130da8802/gr1.jpg

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