隐匿性腹股沟斜疝53例诊断与治疗

Diagnosis and treatment of occult indirect inguinal hernia (A report of 53 cases)

目的提高对隐匿性腹股沟斜疝诊断与治疗水平。方法对不明原因的腹股沟区疼痛患者,当体格检查无阳性发现时行疝囊造影术。确诊后手术治疗。近三年来开展腹腔镜治疗腹股沟疝,发现隐匿疝同时治疗。结果56例疝囊造影术,确诊48例,无假阳性。腹腔镜治疗中发现隐匿性斜疝5例。34例开放手术,腹腔镜手术19例。其中单纯疝囊高位结扎术17例,术后4例2年内复发并再次手术。疝修补术36例,无复发。结论疝囊造影术可提高对隐匿性腹股沟斜疝诊断水平。对成人隐匿性斜疝,主张疝修补术。而腹腔镜在诊治隐匿性斜疝有重要价值。

Objective To enhance the ability of diagnosis and therapy for occult indirect inguinal hernia. Methods For patients with inguinal region pain of unclear causes herniography was performed when there is nopositive reaction in physical examination. After confirmation they were treated by operation. For the recent three years laparoscope is used to cure indirect inguinal hernia. Results 48 out of 56 cases had hernias confirmed by herniography there was no false-positive herniogram. 5 cases of occult indirect inguinal hernia was found by laparoscopy. 34 cases was performed open operation 19 cases was performed laparoscopy. 17 cases was performed high ligation of the hernial sac. Relapse occurred in 2 cases within 2 years and performed operations again. 36 cases was performed repair of hernia and there were no recurrences. Conclusions The ability of diagnosis for occult indirect inguinal hernia can be enhanced by herniography. For occult indirect inguinal hernia in adults repair of hernia is suggested. Laparoscopy is of great value in diagnosis and treatment of occult indirect inguinal hernia.