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以肠梗阻为表现的闭孔疝:病例报告及CT影像分析

Obturator hernia presenting with intestinal obstruction: A case study and CT imaging insights.

作者信息

Lucio Carlos Eduardo, Ricardo Juan Camilo, Acosta Lina María, Saavedra Santiago, Pérez María Carolina

机构信息

School of Medicine and Health Sciences, Universidad del Rosario, St. 12c #6-25, Bogotá, Colombia.

Department of Radiology and Diagnostic Imaging, Fundación Cardioinfantil-Instituto de Cardiología, St. 163a #13B-60, Bogotá, Colombia.

出版信息

Radiol Case Rep. 2025 Aug 28;20(11):5735-5740. doi: 10.1016/j.radcr.2025.08.013. eCollection 2025 Nov.

Abstract

Obturator hernia is a rare but clinically significant cause of intestinal obstruction, particularly in elderly, thin women due to their anatomical predisposition. We present the case of a 79-year-old female with a history of hypertension and hip arthroplasty who developed acute abdominal pain, vomiting, and absence of flatus and bowel movements. Imaging with contrast-enhanced computed tomography (CT) revealed a right obturator hernia containing a small bowel loop, causing intestinal obstruction without signs of ischemia. The patient underwent urgent intraperitoneal obturator herniorrhaphy, during which an incarcerated small bowel loop with congestive changes was identified and found to be viable, recovering fully after reduction. This case highlights the importance of including obturator hernia in the differential diagnosis of bowel obstruction in elderly patients and demonstrates the pivotal role of CT imaging in achieving timely and accurate diagnosis.

摘要

闭孔疝是肠梗阻的一种罕见但具有临床意义的病因,尤其在老年瘦弱女性中,因其解剖学易患因素。我们报告一例79岁女性病例,有高血压和髋关节置换术病史,出现急性腹痛、呕吐,且无排气和排便。增强计算机断层扫描(CT)成像显示右侧闭孔疝,包含一个小肠袢,导致肠梗阻但无缺血迹象。患者接受了紧急腹膜内闭孔疝修补术,术中发现一个有充血改变的嵌顿小肠袢,且发现其仍有活力,复位后完全恢复。该病例强调了在老年患者肠梗阻鉴别诊断中纳入闭孔疝的重要性,并证明了CT成像在实现及时准确诊断方面的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e17a/12414815/4bcbd31d75fd/gr1.jpg

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