• 內(nèi)蒙古醫(yī)學(xué)院附屬醫(yī)院胃腸外科(內(nèi)蒙古呼和浩特 010050);

目的  探討閉孔疝的診斷和治療方法。
方法  回顧性分析了我院2001年10月至2009年8月期間收治并經(jīng)手術(shù)證實(shí)的8例閉孔疝患者的臨床資料。
結(jié)果  8例均為女性,其中7例是老年、體弱的多產(chǎn)婦,1例是已婚年輕女性。平均年齡74.6歲(46~85歲),平均體重為39.1 kg(34~43 kg),平均生育5胎(1~10胎)。8例患者中5例術(shù)前經(jīng)CT檢查確診而行手術(shù)治療,3例由外院轉(zhuǎn)入者在行急診剖腹探查術(shù)中確診。7例行壞死小腸切除吻合術(shù),1例行嵌頓小腸復(fù)位術(shù)。 術(shù)后4例出現(xiàn)并發(fā)癥:1例肺炎、1例切口感染、1例低蛋白水腫、1例為酸中毒和低血鉀(死亡)。7例痊愈出院,1例死亡。
結(jié)論  閉孔疝缺乏特異性表現(xiàn),對年老體弱的經(jīng)產(chǎn)婦出現(xiàn)腹痛、嘔吐和股部疼痛應(yīng)想到閉孔疝的可能;CT檢查能提高閉孔疝的診斷率。準(zhǔn)確的診斷和及時(shí)的手術(shù)干預(yù)是改善閉孔疝患者預(yù)后的關(guān)鍵。

引用本文: 王華,張兵,董培德. 閉孔疝8 例報(bào)道. 中國普外基礎(chǔ)與臨床雜志, 2012, 19(1): 96-98. doi: 復(fù)制

1. Lo CY, Lorentz TG, Lau PW. Obturator hernia presenting as small bowel obstruction [J]. Am J Surg, 1994, 167(4): 396-398.
2. Hsu CH, Wang CC, Jeng LB, et al. Obturator hernia:a report of eight cases [J]. Am Surg, 1993, 59(11): 709-711.
3. Cubillo E. Obturator hernia diagnosed by computed tomography [J]. Am J Roentgenol, 1983, 140(4): 735-736.
4. Bjork KJ, Mucha P Jr, Cahill DR. Obturator hernia [J]. Surg Gynecol Obstet, 1988, 167(3): 217-222.
5. Gray SW, Skandalakis JE, Soria RE, et al. Strangulated obturator hernia [J]. Surgery, 1974, 75(1): 20-27.
6. Kozlowski JM, Beal JM. Obturator hernia:an elusive diagnosis [J]. Arch Surg, 1977, 112(8): 1001-1002.
7. Yokoyama Y, Yamaguchi A, Isogai M, et al. Thirty-six cases of obturator hernia:does computed tomography contribute topostoperative outcome? [J]. World J Surg, 1999, 23(2): 214-217.
8. Yip AW, Ahchong AK, Lam KH. Obturator hernia: a continuing diagnostic challenge [J]. Surgery, 1993, 113(3): 266-269.
9. Sinha SN, Decosta AE. Obturator hernia [J]. Aust N Z J Surg, 1983, 53(4): 349-351.
10. Yokoyama T, Munakata Y, Ogiwara M, et al. Preoperative diagnosis of strangulated obturator hernia using ultrasonography [J].Am J Surg, 1997, 174(1): 76-78.
11. Ijiri R, Kanamaru H, Yokoyama H, et al. Obturator hernia:the usefulness of computed tomography in diagnosis [J]. Surgery,1996, 119(2): 137-140.
12. Zerbey AL 3rd, Larsen CR, Sanders LE. Bilateral obturator hernias:case report, radiographic characteristics, and brief review of literature [J]. Comput Med Imaging Graph, 1993, 17(6): 465-468.
13. Bergstein JM, Condon RE. Obturator hernia: current diagnosis and treatment [J]. Surgery, 1996, 119(2): 133-136.
14. Nishina M, Fujii C, Ogino R, et al. Preoperative diagnosis of obturator hernia by computed tomography in six patients [J]. J Emerg Med, 2001, 20(3): 277-280.
15. Cueto-García J, Rodríguez-Diaz M, Elizalde-Di Martino A. Incarcerated obturator hernia successfully treated by laparoscopy [J].Surg Laparosc Endosc, 1998, 8(1): 71-73.
16. Kim JJ, Jung H, Oh SJ, et al. Laparoscopic transabdominal preperitoneal hernioplasty of bilateral obturator hernia [J]. Surg Laparosc Endosc Percutan Tech, 2005, 15(2): 106-109.
17. Haith Jr LJ, Simeone MR, Reilly KJ, et al. Obturator hernia:laparoscopic diagnosis and repair [J]. JSLS, 1998, 2(2): 191-193.
18. Miki Y, Sumimura J, Hasegawa T, et al. A new technique of laparoscopic obturator hernia repair:report of a case [J]. Surg Today, 1998, 28(6): 652-656.
19. Losanoff JE, Richman BW, Jones JW. Obturator hernia [J]. J Am Coll Surg, 2002, 194(5): 657-663.
  1. 1. Lo CY, Lorentz TG, Lau PW. Obturator hernia presenting as small bowel obstruction [J]. Am J Surg, 1994, 167(4): 396-398.
  2. 2. Hsu CH, Wang CC, Jeng LB, et al. Obturator hernia:a report of eight cases [J]. Am Surg, 1993, 59(11): 709-711.
  3. 3. Cubillo E. Obturator hernia diagnosed by computed tomography [J]. Am J Roentgenol, 1983, 140(4): 735-736.
  4. 4. Bjork KJ, Mucha P Jr, Cahill DR. Obturator hernia [J]. Surg Gynecol Obstet, 1988, 167(3): 217-222.
  5. 5. Gray SW, Skandalakis JE, Soria RE, et al. Strangulated obturator hernia [J]. Surgery, 1974, 75(1): 20-27.
  6. 6. Kozlowski JM, Beal JM. Obturator hernia:an elusive diagnosis [J]. Arch Surg, 1977, 112(8): 1001-1002.
  7. 7. Yokoyama Y, Yamaguchi A, Isogai M, et al. Thirty-six cases of obturator hernia:does computed tomography contribute topostoperative outcome? [J]. World J Surg, 1999, 23(2): 214-217.
  8. 8. Yip AW, Ahchong AK, Lam KH. Obturator hernia: a continuing diagnostic challenge [J]. Surgery, 1993, 113(3): 266-269.
  9. 9. Sinha SN, Decosta AE. Obturator hernia [J]. Aust N Z J Surg, 1983, 53(4): 349-351.
  10. 10. Yokoyama T, Munakata Y, Ogiwara M, et al. Preoperative diagnosis of strangulated obturator hernia using ultrasonography [J].Am J Surg, 1997, 174(1): 76-78.
  11. 11. Ijiri R, Kanamaru H, Yokoyama H, et al. Obturator hernia:the usefulness of computed tomography in diagnosis [J]. Surgery,1996, 119(2): 137-140.
  12. 12. Zerbey AL 3rd, Larsen CR, Sanders LE. Bilateral obturator hernias:case report, radiographic characteristics, and brief review of literature [J]. Comput Med Imaging Graph, 1993, 17(6): 465-468.
  13. 13. Bergstein JM, Condon RE. Obturator hernia: current diagnosis and treatment [J]. Surgery, 1996, 119(2): 133-136.
  14. 14. Nishina M, Fujii C, Ogino R, et al. Preoperative diagnosis of obturator hernia by computed tomography in six patients [J]. J Emerg Med, 2001, 20(3): 277-280.
  15. 15. Cueto-García J, Rodríguez-Diaz M, Elizalde-Di Martino A. Incarcerated obturator hernia successfully treated by laparoscopy [J].Surg Laparosc Endosc, 1998, 8(1): 71-73.
  16. 16. Kim JJ, Jung H, Oh SJ, et al. Laparoscopic transabdominal preperitoneal hernioplasty of bilateral obturator hernia [J]. Surg Laparosc Endosc Percutan Tech, 2005, 15(2): 106-109.
  17. 17. Haith Jr LJ, Simeone MR, Reilly KJ, et al. Obturator hernia:laparoscopic diagnosis and repair [J]. JSLS, 1998, 2(2): 191-193.
  18. 18. Miki Y, Sumimura J, Hasegawa T, et al. A new technique of laparoscopic obturator hernia repair:report of a case [J]. Surg Today, 1998, 28(6): 652-656.
  19. 19. Losanoff JE, Richman BW, Jones JW. Obturator hernia [J]. J Am Coll Surg, 2002, 194(5): 657-663.