Guivarc'h M, Sbai-Idrissi M S
CMC Foch, Suresnes.
J Chir (Paris). 1995 May;132(5):244-8.
Two patients presented with abdominal wall hernia in the 9th intercostal space on the right. Such localizations are extremely rare, occurring after closed or open chest or abdominal trauma producing two contiguous orifices in the diaphragm and the intercostal chest wall. The diaphragmatic orifice is due to a low lateral disinsertion and the intercostal orifice is situated in the 7th to 11th space, occurring immediately or later. Intercostal abdominal hernias are sometimes discovered due to pain or digestive or respiratory disorders. Clinical diagnosis is simple. CT scan confirms the clinical diagnosis and give a precise description. A direct or abdominal surgical approach is used to close the diaphragmatic orifice and the intercostal space with an unabsorbed suture. Muscle plasty or a unabsorbable prosthesis may be necessary. Early recurrence may occur if the orifice in the diaphragm is ignored.
两名患者在右侧第9肋间出现腹壁疝。这种定位极其罕见，发生在闭合性或开放性胸腹部创伤后，导致膈肌和肋间胸壁出现两个相邻的孔口。膈肌孔口是由于外侧低位附着处分离，肋间孔口位于第7至11肋间，可立即出现或随后出现。肋间腹疝有时因疼痛或消化或呼吸紊乱而被发现。临床诊断简单。CT扫描可证实临床诊断并给出精确描述。采用直接或经腹手术方法，用不可吸收缝线关闭膈肌孔口和肋间间隙。可能需要进行肌肉成形术或使用不可吸收假体。如果忽略膈肌孔口，可能会早期复发。
