診断にＣＴが有用であった盲腸後かヘルニアの１例

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  • A CASE OF RETROCECAL HERNIA SUCCESSFUL DIAGNOSED BY CT.

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A case of retrocecal type paracecal hernia which is relatively rare is presented. An 84-year-old woman was admitted to the hospital because of sudden onset of abdominal pain and nausea. There was no previous history of undergoing abdominal surgery. On physical examination, the entire abdomen was distended and there was mild tenderness without signs of peritonitis. Plain abdominal X-ray films showed the dilated small intestine with air-fluid level. A radiological enteroclysis showed strictures of the small intestine in the right lower quadrant of abdomen. Abdominal CT scan showed an incarcerated small intestinal loop behind the cecum that was deviated anteriorly. A laparotomy revealed that the ileum at 80cm oral side from the ileum end was incarcerated into a retrocecal cavity. Retrocecal type paracecal hernia was diagnosed. A reduction of the incarcerated loop was followed by an obliteration of the hernia orifice to prevent subsequent incarceration. A dilated small intestinal loop behind the deviated cecum on CT is considered to be a characteristic finding of retrocecal type paracecal hernia. We suggest that the CT finding provides a clue to make the diagnosis.

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