Incarcerated Hernia in a Trocar Cystostomy Site: A Case Report

膀胱造瘻造成之嵌頓性腸疝氣：個案報告

王偉林(Wei-Lin Wang) ； 梁宏華(Hung-Hua Liang) ； 魏柏立(Po-Li Wei) ； 王偉(Weu Wang) ； 顏克僼(Ko-Li Yen) ； 吳志雄(Chih-Hsiung Wu) ； 徐偉峻(Wayne Hsu)

《輔仁醫學期刊》 8卷2期 (2010/06) Pp. 105-109

摘要

在微創手術普及的時代，腹腔鏡套管造成之切口，雖然較傳統手術傷口來的小，但仍有切口疝氣的發生。切口疝氣的發生，與患者的肥胖、腹水等等長期腹壓升高有關。但由恥骨上膀胱造瘻的小切口造成切口疝氣，則十分少見。在我們的個案報告中，患者因腸阻塞至急診求助，未有外科手術史，但患者因攝護腺肥大而接受過經尿道攝護腺刮除手術(TURP)合併恥骨上膀胱造瘻，最後診斷為膀胱造瘻造成之嵌頓性腸疝氣合併腸壞死，在手術後切除壞死的小腸合併疝氣修補後恢復良好。
回顧文獻，微創手術傷口即使小至2mm，仍有嵌頓性腸疝氣之病例報告，故若腸阻塞患者曾接受過微創手術，嵌頓性腸疝氣為不能排除的鑑別診斷之一，及早手術治療才能避免腸道的壞死。

關鍵字

膀胱造瘻 ； 腸疝氣

並列摘要

An incarcerated hernia through a suprapubic catheterization site is rare. Attention is required for such hernias as they may become obstructed due to the narrow neck. We report an 83yearold male patient without a history of a laparotomy. The patient had received transurethral resection of the prostate (TURP) with insertion of a suprapubic catheter 10 years previous. A rare presentation of an obstructed incisional hernia through the suprapubic catheterization site in this elderly gentleman was noted, which could not be reduced. Segmental resection of the incarcerated small bowel and repair of the hernia were successfully performed.

並列關鍵字

Trocar cystostomy ； hernia