对于绞窄性里氏疝来说,早期手术干预至关重要。

IF 0.4 Q4 SURGERY Journal of Surgical Case Reports Pub Date : 2024-10-11 eCollection Date: 2024-10-01 DOI:10.1093/jscr/rjae642
Christopher R Smith, Michail Chatzikonstantinou
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引用次数: 0

摘要

里氏疝是一种罕见但严重的外科急腹症,涉及部分肠管周缘被疝孔夹住或绞窄,通常不会造成完全的管腔阻塞。本病例报告描述了一名 70 多岁的男性,尽管排便正常,但出现腹痛和呕吐症状已有 3 天。血检结果显示炎症标志物升高,计算机断层扫描成像显示左腹股沟疝嵌顿导致小肠梗阻。急诊手术确诊为里氏疝,肠环被绞窄,但仍然存活。及早的手术干预使患者获得了良好的治疗效果。该病例强调,在处理里氏疝时,高度怀疑、及早转诊和及时进行影像学检查对于预防坏疽和穿孔等严重并发症非常重要。尽管没有梗阻性症状,但当临床担心出现绞窄时,早期手术干预至关重要。
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Early surgical intervention is critical for strangulated Richter's hernia.

Richter's hernia is a rare but serious surgical emergency involving the entrapment or strangulation of part of the bowel's circumference in the hernial orifice, often without causing complete luminal obstruction. This case report describes a man in his 70s presenting with a 3-day history of abdominal pain and vomiting, despite normal bowel movements. Blood results revealed raised inflammatory markers, and computed tomography imaging suggested small bowel obstruction due to an incarcerated left inguinal hernia. Emergency surgery confirmed a Richter's hernia with a strangulated but viable bowel loop. Early surgical intervention led to a positive outcome. This case underscores the importance of high suspicion, early referral, and timely imaging in managing Richter's hernia to prevent severe complications, such as gangrene and perforation. Despite the absence of obstructive symptoms, early surgical intervention is critical when there is clinical concern regarding strangulation.

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来源期刊
CiteScore
0.70
自引率
0.00%
发文量
559
审稿时长
11 weeks
期刊最新文献
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