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題名 | Richter's Hernia--A Report of Six Cases=Richter's疝氣--六例報告 |
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作者 | 杜世興; 黃清水; 李興中; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 26:6 民82.11-12 |
頁次 | 頁2079-2084 |
分類號 | 416.2423 |
關鍵詞 | Richter's疝氣; Richter's hernia; Inguinal hernia; Obturator hernia; Femoral hernia; |
語文 | 英文(English) |
中文摘要 | 國泰綜合醫院自1985年6月至1991年6月間,共經驗六例Richter's疝氣,其中女性5例,男性1例。患者皆屬於高年齡群且體重偏輕,年齡自67歲至76歲,平均年齡為72歲。所有病例都是在剖腹探查術時才正確診斷為Richter's疝氣。其中有2例發生於右側腹股溝疝氣袋,2例發生於左側閉孔疝氣,1例發生於右側股疝氣,另1例發生右側閉孔疝氣中。臨床上6例中4例以不完全腸阻塞的症狀為表現,1例呈現腹膜炎及敗血性休克,另1例呈現大量腹壁膿瘍合併自發性的腸道皮膚瘻管。所有病例都先接受壞死的腸段切除及吻合術,其中5例並於同時修補疝氣,其餘1例則於第二次手術時進行修補。在本系列中雖然有兩例術後的恢復過程相當困難及複雜,不過最後所有病例皆能完全康復後出院。我們認為在高齡體重過輕的不完全腸阻塞病人,鑑別診斷時,應考慮到Richter's疝氣,以避免發生高併發症及死亡率。 |
英文摘要 | From June 1985 to June 1991, six cases of Richter's hernia were diagnosed at the Cathay General Hospital. Five out of the six patients were female; the other, male. Patients' ages ranged from 67 to 76 years with a mean of 72 years; all were geriatric patients, and under-weight. The diagnoses were all made during laparotomy. The incarcerated sites were right inguinal hernia intwo, right obturator hernia in one, right femoral hernia in one, left obturator hernia in Two. Four of the six patients presented with symptoms of partial intestinal obstruction; one presented with symptoms of peritonitis and septic shock after elective femoral hernia repair and the other presented with symptoms of abdominal wall abscess with spontaneous enterocutaneous fistula. All six cases received segmental resection of the devitalized intestines with end-to-end or functional end-to-end anastomosis, and repair of the abdominal wall defect in one or two staged operations. The postoperative courses were complicated in two, but all patients eventually recovered. It was concluded that when incomplete ileus occurs in the underweight elderly patient, the possibi1ity of Richter's hernia must be considered. Such diagnosis reduces the morbidity and mortality of Richter's hernia. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。