CTによる非嵌頓閉鎖孔ヘルニア診断の可能性について  [in Japanese] COMPUTED TOMOGRAPHIC DIAGNOSIS OF NON STRANGULATED OBTURATOR HERNIA  [in Japanese]

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Abstract

5例の閉鎖孔ヘルニア嵌頓例をもとにCTから非嵌頓時の診断の可能性について検討した.5症例より嵌頓時のCT画像が7カ所,非嵌頓時のCT画像が10カ所認められた.非嵌頓時のCT画像は臨床症状および臨床経過から判断した.非嵌頓時のCT画像を検討するためCT所見と外閉鎖筋と恥骨筋間隙の距離を正常女性20例とともに計測した.結果,非嵌頓時の閉鎖孔ヘルニアの外閉鎖・恥骨筋間隙の距離は平均9mm,嵌頓時は24mm,健常者は3.8mmで非嵌頓時と健常者の間では有意差が認められた.また,CT上は正常時には外閉鎖・恥骨筋間隙には均一な帯状の低吸収域が認められるが,非嵌頓時には10カ所中5カ所に線状,棍棒状の軟部組織影が認められた.以上より閉鎖孔ヘルニア非嵌頓時においてもCT上,外閉鎖・恥骨筋間隙が10mm以上に拡大し,さらに軟部組織陰影が認められた場合には閉鎖孔ヘルニアが疑われた.

We report the computed tomographic diagnosis of non strangulated obturator hernia. We treated 5cases of obturator hernia, in which 3 cases had ileocecalgia and thigh pain due to obturator hernia for many years and received CT examinations when occurred that pain. Retrospectively, any CT revealed non strangulated obturator hernia in 3 cases. We investigated any features of non strangulated obturator hernia from CT exam, and measured the interval of external obturator muscle and pectineal muscle on CT films of obturator hernia's patients and 20 healthy elderly women. On the result, the interval of external obturator muscle and pectineal muscle is average length of 9 mm in cases of non strangulated obturator hernia,24mm in cases of strangulated obturator hernia and 3.8mm in 20 healthy eldely women, which is shorter significantly than that of non strangulated obturator hernia. In the cases of non strangulated obturator hernia, CT revealed linear and nodular high density shadow in the space of external obturator muscle and pectineal muscle, but in the cases of normal women, nothing. We concluded that non strangulated obturator hernia is suspected by CT examination when the interval of external obturator muscle and pectineal muscle is larger than 10mm and linear and nodular high density shadow is appeared in the space of external obturator muscle and pectineal muscle.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 62(2), 353-357, 2001-02-25

    Japan Surgical Association

References:  9

Cited by:  16

Codes

  • NII Article ID (NAID)
    10008387980
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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