Obturator hernia is an unsuspected diagnosis
Obturator hernia is an unsuspected diagnosis
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DOI：
10.1016/s0002-9610(97)00024-x
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发表时间：
1997-07-01
影响因子：
3
通讯作者：
Bongard, F
中科院分区：
文献类型：
--
作者：
Naude, G;Bongard, F
背景技术：我们介绍了6例闭孔疝患者，来自Harbor-UCLA医学中心和南非Natalspruit医院，使英文文献中的总数达到676例。本研究进行检查的陷阱，在诊断和治疗这种高度致命的conditions.PATIENTS的方法：所有患者均为女性，平均年龄为79岁。所有患者均消瘦，一般状况较差，伴痴呆（4例）、气道疾病（3例）、心脏病（3例）和播散性癌（1例）。6例患者中5例在开腹手术时确诊。结果：诊断是由一个肿块在大腿上部，感觉阴道或直肠，和一个积极的Howship-Romberg和/或Hannington-Kiff征。X线片、对比研究、计算机断层扫描和疝造影有助于诊断。在紧急情况下，下中线剖腹术是首选。结论：由于患者的病情较差和诊断延误，死亡率（10%~50%）是常见的。早期诊断可能会降低与这种情况相关的高发病率和死亡率。(C)1997年，Excerpta Medica，Inc.
BACKGROUND: We present 6 patients with obturator hernia, from Harbor-UCLA Medical Center and Natalspruit Hospital, South Africa, bringing the total in the English literature to 676. This study was undertaken to examine the pitfalls in diagnosis and methods of treatment of this highly fatal condition.PATIENTS: All patients were women, with an average age of 79 years. All were emaciated and in poor general condition, with dementia (4 patients), airway disease (3), cardiac disease (3), and disseminated carcinoma (1). For 5 of the 6 patients, the diagnosis was made at laparotomy. One patient died postoperatively.RESULTS: The diagnosis was made from a lump in the upper thigh, felt vaginally or rectally, and a positive Howship-Romberg and/or a Hannington-Kiff sign. Radiographs, contrast studies, computed tomography scans, and herniography are helpful in making a diagnosis. In an emergency situation, lower midline laparotomy is preferred. Electively, other procedures and laparoscopic repair may be performed.CONCLUSION: Mortality (10% to 50%) is common due to the poor condition of the patients and the delay in diagnosis. Earlier diagnosis may lower the high morbidity and mortality associated with this condition. (C) 1997 by Excerpta Medica, Inc.