Lindsey I, Nottle P D
Department of Surgery, Alfred Hospital, Prahran, Victoria, Australia.
Surg Laparosc Endosc. 1997 Aug;7(4):349-50.
Laparoscopy is not commonly used in the management of small bowel obstruction (SBO). We report the first documented case of laparoscopic diagnosis and treatment of a retrocaecal hernia, a type of internal abdominal hernia. An 86-year-old woman with a chest infection was referred with features of a well-established SBO. At laparoscopy, the hernia was quickly diagnosed and easily reduced, the bowel assessed for viability, and the sac treated by widely laying open its neck, thereby marsupializing the defect. A laparotomy was avoided, and she recovered promptly and without complication. We conclude that laparoscopy can play a useful role in the management of SBO and that its use should be considered in patients with no obvious external hernia and a virgin abdomen in whom an unusual cause is suspected.
腹腔镜检查在小肠梗阻（SBO）的治疗中并不常用。我们报告首例经文献记载的腹腔镜诊断和治疗盲肠后疝（一种腹内疝类型）的病例。一名患有胸部感染的86岁女性因确诊的SBO症状而前来就诊。在腹腔镜检查中，疝很快被诊断出来并易于回纳，对肠管的活力进行了评估，通过广泛敞开疝囊颈部对疝囊进行处理，从而使缺损袋形化。避免了开腹手术，她恢复迅速且无并发症。我们得出结论，腹腔镜检查在SBO的治疗中可发挥有益作用，对于无明显外部疝且腹部未手术、怀疑有异常病因的患者，应考虑使用腹腔镜检查。
