Ozenç A, Ozdemir A, Coskun T
Department of Surgery, Hacettepe University School of Medicine, Ankara, Türkiye (Turkey).
Int Surg. 1998 Apr-Jun;83(2):167-70.
Congenital bands, congenital anomalies of the intestinal rotation and congenital defects in the mesentery or omentum, postsurgical or traumatic defects of the mesentery and omentum are important factors that predispose to internal herniation. In this retrospective study, 18 cases of internal herniation were evaluated and the factors that effect the prognosis were investigated.
The records of 609 patients who underwent laparotomy due to acute intestinal obstruction were retrospectively reviewed. The cause of intestinal obstruction was internal herniation in 18 patients. The patients were evaluated with respect to signs and symptoms, radiological findings, time elapsed between the onset of symptoms and surgery, findings, in surgery, type of operation performed, postoperative complications and postoperative stay.
Postoperative complications were encountered more frequently in the patients with bowel strangulation (p=0.045) in our series. Time elapsed between the onset of symptoms and laparotomy was found to be significantly longer in the patients with strangulation than in those without strangulation (p=0.046). Additionally, postoperative hospital stay was shorter in the patients without strangulation (p=0.03).
Since preoperative diagnosis of an internal herniation is very difficult because of the lack of specific signs and symptoms, postoperative complications can only be decreased with early surgical intervention in the patients with acute intestinal obstruction.
先天性束带、肠道旋转先天性异常以及肠系膜或网膜先天性缺陷，肠系膜和网膜的术后或创伤性缺陷是易导致内疝形成的重要因素。在这项回顾性研究中，对18例内疝患者进行了评估，并调查了影响预后的因素。
回顾性分析609例因急性肠梗阻接受剖腹手术患者的病历。18例患者肠梗阻的病因是内疝。对患者的症状体征、影像学检查结果、症状发作至手术的时间、手术中的发现、所施行的手术类型、术后并发症及术后住院时间进行评估。
在我们的系列研究中，肠绞窄患者术后并发症的发生率更高（p=0.045）。发现绞窄患者症状发作至剖腹手术的时间明显长于无绞窄患者（p=0.046）。此外，无绞窄患者的术后住院时间较短（p=0.03）。
由于缺乏特异性症状体征，内疝的术前诊断非常困难，对于急性肠梗阻患者，只有通过早期手术干预才能降低术后并发症的发生率。
