盆腔闭孔疝的临床及CT征象分析

Multi-slice CT findings and clinical analysis of obturator hernia

目的分析盆腔闭孔疝的多层螺旋CT表现及临床特点。方法分析2007年1月～2012年1月我院收治的11例盆腔闭孔疝患者的CT征象，并结合患者性别、年龄、体重、生育史、临床表现进行分析，同时将CT和手术结果进行对比。结果11例患者共计13侧闭孔疝，术前CT检查表现闭孔外肌与耻骨肌间肠管样填充物8例；在闭孔管中上段表现为索状软组织影5例，其中2例为双侧闭孔疝；手术证实右侧闭孔疝8例，左侧5例；11侧疝内容物为肠管，2侧疝人物为网膜和卵巢，其中2例疝入肠管缺血坏死。术后均治愈出院，无重大并发症发生。结论闭孔疝多发生于年老消瘦且有多次妊娠史的女性，右侧多于左侧，术前CT检查可明确诊断，早期CT检查及手术是提高治愈率的关键。

Objective To analyze multi - slice CT findings and clinical significance of obturator hernia. Methods The CT findings of 11 cases with obturator hernia confirmed by surgery were analyzed retrospectively from 2007 to 2012 in our hospital. These data were also analyzed including their age, gender, body weight, delivery history and clinical manifestations. The correlation was explored between the CT findings and the surgical results. Results Eleven cases with obturator hernia were 13 sides in total. Preoperative CT examination showed in- testine - like filler between lateral obturator muscle and pectineus muscle in 8 cases, and showed soft tissue shade in middle and superior parts of the obturator canal, 2 cases with bilateral obturator hernia among them. Surgery confirmed that 8 sides of obturator hernia were in the right, other 5 sides were in the left. 11 sides with obturator hernia were small bowel, 2 sides of all cases were omentum and ovarian. 2 sides with incarceration and necrosis. All patients were discharged from hospital with no major complications occurred. Conclusion Obturator hernia mostly occurs in the old skinny women. Right side obturator hernia outnumbered left side hernia . Preoperative CT examination can confirm the diagnosis. Early CT examination and surgery is the key to improve the rate of cure.