妇科腹腔镜术后5mm Trocar部位疝2例CT表现与临床对照分析

Comparative Study of CT and Clinical Manifestations of 5 mm Trocar Site Hernia After Gynecological Laparoscopic Surgery: Two Cases Reports and Literature Review

目的分析腹腔镜术后Trocar部位疝(trocar site hernia,TSH)的CT表现特点以及与临床之间的关系。资料与方法回顾性分析经手术证实的2例腹腔镜术后TSH并发肠梗阻患者的CT影像学资料并与临床手术对照,结合相关文献对其发生率、发病机制、分型、临床表现进行分析,探讨该病的CT诊断特点。结果 2例患者CT像上均表现为左下腹壁小肠局部疝出并高位小肠梗阻,结合患者手术史,CT均拟诊为TSH;手术也均证实部分小肠嵌顿于Trocar切口内,近端小肠扩张积液。结论 CT对腹腔镜术后TSH的早期诊断和鉴别诊断具有重要价值,对TSH的早期手术治疗也具有很好的指导意义。

Objective To analyze the CT manifestations and clinical features of Trocar Site Hernia（TSH） after Laparoscopic Surgery.Materials and Methods Retrospective study of the CT images of two Cases of 5mm TSH after laparoscopic surgery which were finally confirmed by operation.Review the incidence,pathogenesis,classification and clinical manifestations of TSH seeking to confirm the definition of TSH by CT scanning.Results CT manifestations of the two cases showed local small intestine herniation under the left lower abdominal wall with high small bowel obstruction.According to the history of laparoscopic surgery,both the patients were diagnosed as TSH by CT imaging.The diagnosis of TSH was finally confirmed by operation.Conclusion CT scanning was valuable and important for early or differential diagnosis of TSH after laparoscopic surgery,which was helpful to guide surgical treatment for TSH.