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胆囊切除术后切口疝伴胃出口梗阻

Post-cholecystectomy Incisional Hernia With Gastric Outlet Obstruction.

作者信息

Salman Saad, Shah Muhammad Haseeb, Jehanzeb Sofia, Khan Bashir, Khan Aurangzeb

机构信息

Department of General Surgery, Mardan Medical Complex, Mardan, PAK.

出版信息

Cureus. 2025 Jun 16;17(6):e86169. doi: 10.7759/cureus.86169. eCollection 2025 Jun.

Abstract

An incisional hernia is a common complication after abdominal surgery. The omentum and small bowel are the most commonly herniated intra-abdominal structures through the fascial defect; however, involvement of the stomach in incisional hernia causing gastric outlet obstruction is very rare. We report a case of a 50-year-old female patient who presented with symptoms of intermittent nausea, vomiting, abdominal swelling, and postprandial discomfort. Clinical examination and imaging revealed an incisional hernia containing an antral part and greater curvature of the stomach, causing gastric outlet obstruction. Reduction of the herniated contents, defect closure, and on-lay mesh placement resulted in the resolution of symptoms. Gastric outlet obstruction secondary to incisional hernia is more frequently observed in middle-aged elderly patients who have had previous abdominal procedures and in women with multiple pregnancies. Contrast-enhanced computed tomography (CECT) plays a crucial role in the diagnosis. Surgical repair remains the definitive treatment for hernias to prevent complications. This case highlights the need to consider incisional hernias with gastric herniation as a potential cause for gastric outlet obstruction, especially in patients of geriatric age. Early diagnosis and surgical treatment are important to relieve symptoms and reduce the risk of complications.

摘要

切口疝是腹部手术后常见的并发症。大网膜和小肠是最常通过筋膜缺损疝入腹腔的结构;然而,切口疝累及胃导致胃出口梗阻的情况非常罕见。我们报告一例50岁女性患者,其出现间歇性恶心、呕吐、腹部肿胀和餐后不适等症状。临床检查和影像学检查显示切口疝包含胃窦部和胃大弯,导致胃出口梗阻。将疝内容物还纳、关闭缺损并放置补片修补,症状得以缓解。继发于切口疝的胃出口梗阻在既往有腹部手术史的中老年患者以及多次妊娠的女性中更为常见。增强计算机断层扫描(CECT)在诊断中起关键作用。手术修复仍然是治疗疝以预防并发症的决定性方法。该病例强调了需要将伴有胃疝的切口疝视为胃出口梗阻的潜在原因,尤其是在老年患者中。早期诊断和手术治疗对于缓解症状和降低并发症风险很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bac1/12270517/df34540d50ec/cureus-0017-00000086169-i01.jpg

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