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中华疝和腹壁外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 609 -612. doi: 10.3877/cma.j.issn.1674-392X.2020.06.006

所属专题: 经典病例 文献

临床论著

闭孔疝八例诊治体会
胡仁旺1, 李昂2,(), 曹志新1   
  1. 1. 430030 武汉,华中科技大学同济医学院附属同济医院胃肠外科
    2. 430030 武汉,武汉大学中南医院急救中心
  • 收稿日期:2019-03-01 出版日期:2020-12-20
  • 通信作者: 李昂

Experience in diagnosis and treatment of obturator hernia in eight cases

Renwang Hu1, Ang Li2,(), Zhixin Cao1   

  1. 1. Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    2. Emergency Center, Zhongnan Hospital of Wuhan University, Wuhan 430030, China
  • Received:2019-03-01 Published:2020-12-20
  • Corresponding author: Ang Li
引用本文:

胡仁旺, 李昂, 曹志新. 闭孔疝八例诊治体会[J]. 中华疝和腹壁外科杂志(电子版), 2020, 14(06): 609-612.

Renwang Hu, Ang Li, Zhixin Cao. Experience in diagnosis and treatment of obturator hernia in eight cases[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(06): 609-612.

目的

探讨闭孔疝的临床诊治体会及经验交流。

方法

收集2015年1月至2017年12月华中科技大学同济医学院附属同济医院收治的且术中证实为闭孔疝的8例患者临床资料,分析其诊疗过程及临床表现,总结诊疗经验。

结果

8例患者均行手术治疗,术后均无并发症,安全出院。

结论

闭孔疝临床较少见,临床表现无特异性,术前行多排CT检查,有助于明确诊断。急诊手术治疗为其首选治疗方式,手术预后较好。

Objective

To discuss the clinical experience of diagnosis and treatment of obturator hernia.

Methods

The clinical information of eight patients with obturator hernia confirmed during operation in Tongji Hospital from January 2015 to December 2017, was collected. The diagnosis and treatment process were analyzed, and the experience was summarized.

Results

All patients underwent surgical treatment without complications and discharged safely.

Conclusion

Obturator hernia is rare and its clinical manifestations are not specific. Preoperative multi-slice spiral CT is helpful for the diagnosis. Emergency surgical treatment is the first choice, and the prognosis is good.

表1 8例闭孔疝患者详细临床信息
图1 图中箭头所示为疝内容物,1A、1B、1C分别代表动脉期闭孔疝的连续三个层面影像学表现
图2 图中箭头所示为疝内容物,2A、2B、2C分别代表静脉期闭孔疝的连续三个层面影像学表现
图3 图中箭头所示为疝内容物,3A代表冠状位图像,3B代表矢状位图像
[1]
Otsuki Y, Konn H, Takeda K, et al. Midline extraperitoneal approach for obturator hernia repair[J]. Keio J Med, 2018, 67(4): 67-71.
[2]
de Kok BM, Puylaert JBCM, Zijta FM. Ultrasound-guided reduction of an incarcerated obturator hernia in an elderly patient[J]. J Clin Ultrasound, 2018, 46(6): 415-418.
[3]
Belli AK, Memiş G, Dere Ö, et al. Obturator hernia should be considered in the differential diagnosis of hip and knee pain[J]. Ulus Travma Acil Cerrahi Derg, 2016, 22(6): 575-577. doi: 10. 5505/tjtes. 2016. 91582.
[4]
Ossendorp RR, Mollema R, Richir MC. An elderly, cachexic patient with a painful leg[J]. Ned Tijdschr Geneeskd, 2016, 160: D942.
[5]
Liu J, Zhu Y, Shen Y, et al. The feasibility of laparoscopic management of incarcerated obturator hernia[J]. Surg Endosc, 2017, 31(2): 656-660.
[6]
Kohga A, Kawabe A, Okumura T, et al. Laparoscopic repair is a treatment of choice for selected patients with incarcerated obturator hernia[J]. Hernia, 2018, 22(5): 887-895.
[7]
Kawanaka H, Hiroshige S, Kubo N, et al. Therapeutic Strategy for Incarcerated Obturator Hernia Using Preoperative Manual Reduction and Laparoscopic Repair[J]. J Am Coll Surg, 2018, 226(5): 891-901.
[8]
Shreshtha S. Obturator hernia: An uncommon cause of small bowel obstruction[J]. J Postgrad Med, 2016, 62(4): 267-268.
[9]
Şenol K, Bayam ME, Duman U, et al. Challenging management of obturator hernia: a report of three cases and literature review[J]. Ulus Travma Acil Cerrahi Derg, 2016, 22(3): 297-300.
[10]
Nazarian S, Narayanan A, Chang S. Diagnosis of an obturator hernia by CT[J]. BMJ Case Rep, 2015: bcr2015212239.
[11]
Conti L, Baldini E, Capelli P, et al. Bowel obstruction in obturator hernia: A challenging diagnosis. Int J Surg Case Rep[J]. 2018, 42: 154-157.
[12]
Leitch MK, Yunaev M. Difficult diagnosis: strangulated obturator hernia in an 88-year-old woman[J]. BMJ Case Rep, 2016: bcr2016215428.
[13]
Light D, Razi K, Horgan L. Computed tomography in the investigation and management of obturator hernia[J]. Scott Med J, 2016, 61(2): 103-105.
[14]
Tokushima M, Aihara H, Tago M, et al. Obturator hernia: A diagnostic challenge[J]. Am J Case Rep, 2014, 15: 280-283.
[15]
Sá NC, Silva VCM, Carreiro PRL, et al. Rare case of incarcerated obturator hernia: Case report and review of literature[J]. Int J Surg Case Rep, 2017, 37: 157-160.
[16]
Sawayama H, Kanemitsu K, Okuma T, et al. Safety of polypropylene mesh for incarcerated groin and obturator hernias: a retrospective study of 110 patients[J]. Hernia, 2014, 18(3): 399-406.
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