Obturator Hernia after Traumatic Pelvic Fracture: Report of a Case

閉孔性疝氣是一種罕見的疝氣，與多種促成因子相關，諸如瘦弱，老年女性，及腹壓增加等等。常常由於診斷上的延遲和病人本身內科疾病導致高死亡率。腹部電腦斷層攝影對於臨床有懷疑的病例可以提高正確診斷率。及早手術治療對於減低併發症及死亡率是必須的。我們提出的病例是一位六十八歲的女性，因爲腹脹兩天來到本院急診室。她五年前曾經有過骨盆骨折的病史。腹部電腦斷層攝影顯示右側閉孔性疝氣且合併有腸嵌頓現象，以及變形之骨盆腔及右側髖關節。病人接受緊急手術切除壞死的腸段併行端對端吻合術，而疝氣缺損處則以鄰近腹膜直接修補。我們懷疑骨盆骨折爲此一危險因子。

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並列摘要

Obturator hernia is a rare kind of hernia associated with multiple predisposing factors, such as emaciation, aging females and increased intra-abdominal pressure. The high mortality rate has been reported to be due to diagnostic delay and underlying medical illness. Emergent abdominal computed tomography for suspected cases can raise the preoperative diagnostic accuracy. Surgical intervention as early as possible is necessary to reduce the morbidity and mortality. Here we report a 68-year-old female with symptoms of intestinal obstruction for 2 days, who visited our emergency department. Past history revealed that she had a pelvic fracture 5 years before. Abdominal computed tomography suggested right obturator hernia with bowel incarceration, and showed a deformed pelvis and right hip joint. During exploration, resection of the gangrenous bowel segment and anastomosis with primary anastomosis were performed. The defect was directly repaired by approximation of the adjacent peritoneum. The history of pelvic fracture might also be recognized as a risk factor.

並列關鍵字

obturator hernia ； computed tomography ； pelvic fracture

國際替代計量

Obturator Hernia after Traumatic Pelvic Fracture: Report of a Case

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