Strangulated Obturator Hernia-A Rare Cause of Small Bowel Obstruction: Report of a Case

閉孔疝氣是一種臨床上罕見的疾病，最常發生於瘦弱之老年婦女。在電腦斷層掃瞄攝影尚未普及的年代，術前診斷閉孔疝氣是相當困難的一件事，而延遲診斷與外科手術治療使得此疾病有極高的死亡率。我們報告一閉孔疝氣併發小腸阻塞的案例，她因腹痛及嘔吐至嘉義長庚醫院求診，臨床上因有明顯Howship-Romberg徵象而懷疑閉孔疝氣，電腦斷層掃瞄攝影證實此一診斷，雖然迅速予以外科手術治療，患者仍因瘦弱體質而於術後第二十五天死於肺炎。我們認爲充分熟悉閉孔疝氣的病程再加上電腦斷層掃瞄攝影確定診斷以縮短病發至手術的時間，應有助於降低因閉孔疝氣所引起的腸道壞死、併發症、和死亡率。

關鍵字

腸道阻塞；閉孔疝氣

並列摘要

Obturator hernia is a rare problem which occurs predominantly in elderly, emaciated women. Preoperative diagnosis of oburator hernia was difficult prior to the development of computed tomography scanning. Both delayed diagnosis and delayed surgical intervention contribute to high mortality. This report presents a case of obturator hernia presenting with small bowel obstruction. This suspected diagnosis was based on presence of a classic Howship-Romberg sign and confirmed by a computed tomography scan. Immediate surgical intervention was performed. The patient died of respiratory complications on the 25th postoperative day. Awareness of the natural history of this type of hernia and use of computed tomography scanning for diagnosis can shorten the interval between onset of symptoms and surgery, and should reduce the incidence of gangrenous bowel, its complications, and mortality.

並列關鍵字

intestinal obstruction ； obturator hernia

國際替代計量

Strangulated Obturator Hernia-A Rare Cause of Small Bowel Obstruction: Report of a Case

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