嵌顿闭孔疝一例及其手术治疗的文献综述

Literature review in a sample of obturator hernia and its surgical treatment

闭孔疝是一种罕见的腹壁疝，国内报道不多。闭孔疝早期无特异症状，疝包块很难被触及，大多在小肠梗阻剖腹探查中发现。一般对该病认识不足，术前能确诊者少。国外统计术前确诊率仅22．7％。由于该病患者多为年老体弱者，所以手术危险性大，国外曾有报道病死率高达37．7％～84．3％。以往大宗的病例统计显示肠坏死率也有25％，闭孔疝仍是一个很严重的疾病。该文报告1例肠梗阻的老年消瘦妇女，术前腹盆腔CT诊断右侧嵌顿闭孔疝合并小肠梗阻，获得及时手术成功治疗，同时就嵌顿闭孔疝的手术治疗进行文献综述。

Obturator hernias are rare form of abdominal wall hernia with few reports in China. It has nonspecific symptoms in early stage,and heria lump is hardly touched,so the majority of patients are found incidentally at laparotomy for small bowel obstruction. Very few patients can be diagnosis before operation due to general lack of knowledge of this disease. The preoperative confirmed cases were only 22. 7% in foreign countries. Due to these ill and frail patients,obturator hernias are very serious disease with high risk of operation.The mortality rate ranged from 37. 7% to 84. 3% and the intestinal necrosis rate was also 25% according to the past big cases. Therefore,obturator hernia is still a serious disease. Here report an old thin lady presented with bowel obstruction,thanks to high degree of clinical attention,an incarcerated obturator hernia was diagnosed preoperatively and treated successfully. Literatures were reviewed on its surgical management.