腹壁瘢痕ヘルニアと鑑別を要した半月状線ヘルニアの1例 A CASE OF SPIGELIAN HERNIA DEMANDED DIFFERENTIATION FROM CICATRICAL HERNIA OF THE ABDOMINAL WALL

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59歳女性, 2002年3月21日夜9時頃より腹痛を自覚.徐々に増悪し3月22日当院救急外来受診.右下腹部に10cm大の隆起を認め圧痛あり.腹部CT上,右下腹壁に腸管脱出を認めヘルニアの嵌頓と診断.ヘルニア門は半月状線と考えられたが, 2回の帝王切開の既往があり,腹壁瘢痕ヘルニアも否定できなかった.用手還納は不可能で緊急手術施行.術中所見でヘルニア嚢は外腹斜筋腱膜下に存在し,腹横筋腱膜と内腹斜筋を貫通している半月状線ヘルニアと判明した.ヘルニア内容は小腸,大網であった.術後経過良好で第12病日退院.現在まで再発なし.

A 59-year-old woman was seen at the emergency clinic on March 22, 2002 because of gradually intensifying abdominal pain which started around 9 p. m. on March 21. There were a ridge 10 cm in diameter and tenderness in the right lower quadrant of abdomen. Abdominal CT scan showed prolapsed intestine in the right lower abdominal wall. Incarcerated hernia was thus diagnosed. The hernia opening was thought to be the semilunar line, but the patient had undergone 2 times of cesarean section and a possibility of cicatrical hernia of the abdominal wall could not be ruled out. Reduction of the incarcerated intestine by hands was impossible, and emergency operation was carried out. Upon laparotomy, the hernia sac was present under the musculus obliquus externus abdominis, so that we diagnosed the case as spigelian hernia perforating the lacertus of musculus transverses abdominis and muscles obliquus internus abdominis. The hernia contents were the small intestine and greater omentum. The patient's postoperative course was uneventful, and the patient was discharged from the hospital on the 12<sup>th</sup> hospital day. There have been no signs of recurrence up to now.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 65(8), 2268-2272, 2004-08-25

    日本臨床外科学会

参考文献:  12件中 1-12件 を表示

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各種コード

  • NII論文ID(NAID)
    10013671286
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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