A REPORT OF FOUR CASES OF OBTURATOR HERNIA WITH A STATISTICAL STUDY OF 77 CASES IN JAPAN

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  • 閉鎖孔ヘルニアの4例

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Abstract

Four cases of obturator hernia experienced at the hospital in a recent 5.5-year period are presented, together with a statistical study of 77 cases seen in the Japanese literature since 1990, including our four cases, and diagnosis and therapeutic outcomes of the disease in these years as well as some problems related thereto are discussed.<br> All our four cases were diagnosed preoperatively within 2 days after admission, including one case suspected of this disease based on our previous experience, and three cases being Howship-Romberg's sign positive, wherein two cases were diagnosed definitely by pelvic CT scan. All of them required no resection of the intestine but only reduction of the incarcerated intestine and suture of the obturator. Their postoperative courses were uneventful.<br> In a statistical analysis of the 77 cases collected, the preoperative correct diagnosing rate was noted improved to 72.3% by employment of CT and ultrasonography, while resection of the intestine was noted high in 55.8%, especially in 85.7% with those diagnosed intraoperatively. On the other hand resection of the intestine in those preoperatively diagnosed was noted in 44.6%. Most of them required no resection of the intestine being operated within 2 days after admission. It is considered that recently preoperative diagnosing rate of this disease has improved, but to avoid resection of the intestine, early diagnosis and early operation within 2 days after admission are important.

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