老年急性嵌顿性腹股沟疝合并肠梗阻的危险因素分析及风险列线图模型的建立

目的探讨老年急性嵌顿性腹股沟疝合并肠梗阻（POI）的危险因素及风险列线图模型的建立,为临床护理工作提供参考依据。 方法回顾性分析2012年6月至2018年6月因急性嵌顿性腹股沟疝于我院就诊的259例老年患者的临床资料。按照是否并发POI,分为并发POI组和非POI组。分别使用单因素和Logistic回归多因素分析老年急性嵌顿性腹股沟疝合并发肠梗阻的独立危险因素。然后纳入筛选出的独立危险因素建立列线图预测模型,并对模型的预测性及准确度进行验证。 结果2组患者性别、文化程度、身体质量指数、高血脂、高血压、冠心病、吸烟史、酗酒史、术前贫血和手术时间等信息的比较,均无统计学差异（χ²=0.239,0.324,0.179,0.485,0.282,0.069,0.402,0.146,0.108,0.994;P>0.05）,而年龄、糖尿病、恶性肿瘤、腹部手术史、嵌顿时间和术后感染等资料差异有统计学意义（χ²=5.963,9.954,17.644,17.281,9.154,8.831;P<0.05）。以并发POI情况为因变量,以并发POI组和非POI组单因素分析中有统计学意义的6个项目（年龄、糖尿病、恶性肿瘤、腹部手术史、嵌顿时间、术后感染）为自变量,进行多元Logistic回归分析,结果表明,年龄、糖尿病、恶性肿瘤、腹部手术史、嵌顿时间及术后感染是老年急性嵌顿性腹股沟疝并发POI的独立危险因素,具有统计学差异（OR=3.515,4.506,8.805,17.526,3.937,2.770,0.015;95% CI：1.437～8.601,1.519～13.372,2.349～33.011,3.986～77.067,1.615～9.598,1.147～6.686;P<0.05）,均与老年急性嵌顿性腹股沟疝并发POI高度相关。基于年龄、糖尿病、恶性肿瘤、腹部手术史、嵌顿时间和术后感染这6项老年急性嵌顿性腹股沟疝并发肠梗阻的独立危险因素,建立预测老年急性嵌顿性腹股沟疝并发肠梗阻的列线图模型,经验证,其预测值同实测值基本一致,说明本研究的列线图预测模型具有较好的预测能力,同时本研究该列线图模型使用Bootstrap进行内部验证法,C-index指数高达0.846（95% CI：0.812~0.880）,模型对于老年急性嵌顿性腹股沟疝并发POI诊断的ROC也高达0.846,说明本研究列线图模型具有良好的精准度和区分度。 结论老年急性嵌顿性腹股沟疝并发肠梗阻的风险较高,年龄、糖尿病、恶性肿瘤、腹部手术史、嵌顿时间和术后感染是老年急性嵌顿性腹股沟疝并发肠梗阻的独立危险因素,相关列线图预测模型的建立能够提高对老年急性嵌顿性腹股沟疝并发肠梗阻的诊断效能,为进一步优化护理模式提供方向,临床应用价值较高,值得进一步推广使用。     

腹腔镜胆囊切除术早期并发症的临床风险因素分析

目的:探讨腹腔镜胆囊切除术(LC)早期(术中与术后早期)并发症的危险因素,为其防范提供预警。方法:回顾2000年7月—2014年8月施行的16 032例行LC患者资料,分析患者的一般资料与早期并发症发生情况,对引起术后早期并发症的可疑因素行单因素分析筛选与多因素分析确认。结果:16 032例患者的平均年龄为(56.7±21.3)岁;男女比例为1:1.87,其中择期手术14 101例(88.0%),急诊手术1 931例(12.0%);发生早期并发症1 420例(8.9%)。单因素分析结果显示,性别、胆囊炎症情况、肥胖、上腹部手术史、急诊手术、手术持续时间、术者施行LC例数可能是影响LC术早期并发症的危险因素(均P0.05);多因素Logistic回归分析结果显示,男性(OR=10.012,P=0.002)、胆囊急性炎症(OR=2.510,P=0.010)、BMI≥25 kg/m2(OR=3.105,P=0.023)、合并上腹部手术史(OR=7.882,P=0.030)和手术持续时间≥60 min(OR=8.634,P=0.001)是引起LC术早期并发症的独立风险因素。结论:男性、胆囊急性炎症、肥胖、上腹部手术史和长时间手术是LC术早期并发症的独立危险因素,对于具有这些因素的患者,术前及术后应采取积极措施预防其发生。     

补片疝修补术与传统疝修补术治疗腹股沟嵌顿疝疗效的对比

比较使用补片行无张力疝修补与传统疝修补治疗急诊嵌顿性腹股沟疝的临床疗效。收集2014年4月—2018年11月青岛大学医学院第二附属医院收治的78例嵌顿性腹股沟疝患者的临床资料,均为急诊手术患者,其中行腹膜前无张力修补35例(观察组),传统疝修补术43例(对照组)。两组在年龄、性别、基础疾病、ASA分期、疝种类、疝发生部位等方面差异无统计学意义(P0.05);两组疝囊内液体性状无差异,术后感染率、主要并发症发生率差异无统计学意义(P0.05);观察组复发率低于对照组(P0.05);嵌顿肠管坏死患者均同期行坏死部分肠切除术,对照组患者数量较观察组多(P0.05),两种术式均有肠正常及充血水肿患者;无张力修补术患者较传统修补术患者的手术时间及住院时间明显缩短(P0.05)。对于同期行肠切除术的患者,无论选择无张力修补或传统修补治疗,较不切除患者在手术时间、术后感染、主要并发症发生率及复发概率方面差异无统计学意义(P0.05),但住院时间明显增加(P0.05)。对于腹股沟嵌顿疝行急诊手术治疗方式的选择上,使用补片行无张力修补较传统修补是安全、可行的,并且可缩短手术时间,加快术后肠功能的恢复,进而缩短住院时间,并降低了术后复发的可能性。同期行肠切除患者选择补片修补住院时间缩短,其余无差异,采取补片修补同样也是安全、可行的。     

导致腹股沟疝临床路径负性变异的影响因素分析

目的 分析导致腹股沟疝临床路径负性变异的影响因素.方法 选择2012年6月-2014年12月收治的腹股沟疝临床路径病例160例,进行回顾性调查,对可能导致腹股沟疝临床路径负性变异的主要影响因素进行统计分析.结果 单因素分析显示,年龄(P =0.021)、病程(P =0.034)、治疗组(P=0.008)、疝分类(P=0.035)、围术期并发症(P =0.048)、术后住院天数(P=0.000)、术前合并症(P=0.001)与腹股沟疝临床路径负性变异有关(均P＜0.05).Logistic回归分析表明,腹股沟疝临床路径负性变异的危险因素为围术期并发症(OR=15.291,P=0.010)和术前合并症(OR=5.320,P=0.010).结论 术前合并症、围术期并发症是导致腹股沟疝临床路径负性变异发生的主要影响因素.     

腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石手术困难因素分析及临床对策

目的:探讨腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的困难因素,并提出相应的临床对策。方法:回顾分析2013年9月至2018年10月为116例患者行腹腔镜胆囊切除(LC)联合腹腔镜胆总管探查(LCBDE)的临床资料,按手术时间、是否中转开腹、有无结石残留分组,应用单因素分析及多因素Logistic回归分析,探讨LC联合LCBDE手术困难的独立危险因素。结果:116例患者中容易组63例、困难组53例。单因素分析显示:胆囊大小、胆囊壁炎症严重程度、胆囊三角解剖关系显露情况、胆总管下段有无结石嵌顿及胆总管直径均是LC联合LCBDE手术难度较大的危险因素(P<0.05)。多因素Logistic回归结果显示,胆囊三角显露不清(OR=14.090,P<0.001)、胆囊壁化脓坏疽(OR=20.057,P=0.011)、胆总管下段结石嵌顿(OR=23.001,P=0.006)及胆总管直径≥12 mm(OR=3.950,P=0.008)是LC联合LCBDE手术困难的独立危险因素。结论:胆囊结石合并胆总管结石伴有胆囊三角显露不清、胆囊壁化脓坏疽、胆总管下段结石嵌顿、胆总管直径≥12 mm时,LC联合LCBDE的手术困难、危险性明显增加,临床应重视此类患者的术前评估及术中操作,以降低手术困难发生率。     

老年腹股沟疝患者微创修补术后复发的影响因素分析及预防建议

目的：探讨分析老年腹股沟疝患者微创修补术后复发的因素及预防建议。方法：回顾230例老年腹股沟疝微创修补术后患者资料，总结可能导致术后复发的危险因素，并进行Logistic回归分析。结果：21例患者复发，复发率为9.13%，其中术后1年复发6例，术后2年复发9例，术后3年复发4例，术后5年复发2例；复发组男性、术前合并糖尿病、术前合并心脏病、术前合并高血压、嵌顿疝、急诊手术、复发疝、手术时间>30 min、聚四氟乙烯补片、BMI>24.9 kg/m2、直疝、疝环重度粘连、手术医师经验不足3年等构成比均明显高于未复发组（P<0.05）。Logistic回归分析证实以上因素均为老年腹股沟疝患者微创修补术后复发的独立危险因素（OR=19.279、4.289、5.403、4.577、4.491、5.078、5.613、5.094、4.614、5.063、6.417、5.778、5.546,P<0.05）。结论：男性、BMI、术前合并糖尿病、术前合并高血压、术前合并心脏病、嵌顿疝、急诊手术、直疝、复发疝、疝环重度粘连、手术时间长、聚四氟乙烯补片、医师经验不足3年等均是老年腹...     

经腹腹膜前疝修补术后腹内疝性肠梗阻的发生情况及其影响因素分析

目的分析腹腔镜经腹腹膜前疝修补术（TAPP）后腹内疝性肠梗阻的发生情况及其影响因素。 方法选取2018年1月至2021年12月北京同仁医院收治的404例腹股沟疝行TAPP术后患者作为研究对象,根据腹内疝性肠梗阻的发生情况将其分为发生组（38例）和未发生组（366例）,分析所选腹股沟疝行TAPP术后患者的临床资料,采用单因素和Logistic回归分析筛选腹股沟疝患者行TAPP术后发生腹内疝性肠梗阻的影响因素。 结果404例患者术后发生腹内疝性肠梗阻38例（9.41%）;2组患者临床资料对比显示年龄、体质量指数（BMI）、疝囊直径、是否嵌顿疝、手术时间以及术中出血量等资料比较,差异均有统计学意义（均P<0.05）;Logistic回归分析结果表明,BMI>24 kg/m²（OR=3.278,95% CI：1.561～6.886,P=0.002）、疝囊直径>5 cm（OR=3.353,95% CI：1.602～7.022,P=0.001）、嵌顿疝（OR=3.208,95% CI：1.546～6.657,P=0.002）、手术时间>100 min（OR=2.437,95% CI：1.174～5.058,P=0.017）、术中出血量>10 ml（OR=2.733,95% CI：1.303～5.735,P=0.008）是TAPP术后发生腹内疝性肠梗阻的独立危险因素。 结论BMI>24 kg/m²、疝囊直径>5 cm、嵌顿疝、手术时间>100 min、术中出血量>10 ml是TAPP术后发生腹内疝性肠梗阻的独立危险因素,医务人员可以通过危险因素尽早识别高风险患者,还可对可以控制的危险因素给予一定的干预措施,以最大能力防止腹内疝性肠梗阻的发生。     

肠脂肪酸结合蛋白和 D-乳酸在早期诊断嵌顿疝肠坏死中的应用研究

目的 探讨肠脂肪酸结合蛋白(I-FABP)和D-乳酸(D-LAC)早期诊断嵌顿疝肠坏死的价值。方法:选取36只SD大鼠,实验组(n=18)制作嵌顿疝动物模型,对照组(n=18)未制作。在术后30 min、2 h、4 h、6 h、8 h和12 h,采用ELISA检测两组血清D-LAC和I-FABP的水平;RT-qPCR鉴定嵌顿疝肠管组织中I-FABP的表达。通过嵌顿肠管大体标本、苏木素伊红(HE)染色和Chiu’s评分判定肠坏死情况。结果:与对照组相比,实验组在术后6 h时嵌顿肠管大体标本和HE染色呈典型肠绞窄表现,Chiu’s评分有统计学意义(P=0.001),血D-LAC明显升高(P=0.002);8 h时肠管逐渐向肠坏死过渡,血D-LAC进一步升高(P=0.012),血I-FABP也明显升高(P=0.001),并且肠组织中的I-FABP表达明显升高(P=0.002)。12 h时肠管呈现明显肠坏死特征、Chiu’s评分有统计学意义(P=0.001),血D-LAC和I-FABP均升至最高[(2019.60±16.17)μg/L vs(273.18±14.63)μg/L,P=0.001;(1210.94±5.96)μg/L vs (220.46±9.63)μg/L,P=0.001];肠管组织中的I-FABP表达最高[(8.20±0.60)μg/L vs (1.13±0.16)μg/L,P=0.001]。结论:嵌顿疝大鼠血清I-FABP和D-LAC水平升高,为早期诊断嵌顿疝肠管坏死的临床研究提供了依据。     

髋部骨折老年患者发生严重术后谵妄的多因素分析

目的探讨髋部骨折老年患者发生严重术后谵妄的危险因素。方法回顾性分析我院骨科2005年1月~2014年12月572例髋部骨折老年患者接受内固定手术的临床资料,对性别、年龄、术前内科合并症、术前卧床时间、手术方式、麻醉方式、手术时间和术中出血量进行单因素分析,多因素logistic回归模型分析髋部骨折老年患者发生严重术后谵妄的危险因素。结果 25例发生严重术后谵妄(25/572,发生率4.4%)。单因素分析结果显示年龄和麻醉方式有统计学差异(P0.05);多因素logistic回归分析显示年龄(OR=1.12,95%CI:1.05~1.19,P=0.001)和全身麻醉(OR=5.03,95%CI:2.10~12.04,P=0.000)是髋部骨折老年患者发生严重术后谵妄的独立危险因素。结论年龄和全身麻醉是髋部骨折老年患者发生严重术后谵妄的独立危险因素。     

腹腔镜输卵管妊娠保守性手术后发生持续性异位妊娠的多因素分析

目的探讨腹腔镜输卵管妊娠保守性手术后发生持续性异位妊娠(persistent ectopic pregnancy,PEP)的相关危险因素。方法回顾性分析2002年1月~2015年2月我院237例因输卵管妊娠行腹腔镜保守性手术的临床资料,根据术后是否发生PEP分为PEP组和非PEP组。单因素分析包括年龄、停经时间、术前24 h内血β-hCG、包块直径、妊娠部位、腹腔积血、盆腔粘连、手术时间、术中出血量、手术方式、术中是否切除黄体和使用甲氨蝶呤(MTX),并应用logistic回归进行多因素分析。结果术后发生PEP 14例(5.9%)。单因素分析显示术前24 h内血β-hCG、包块直径、手术方式、术中是否切除黄体和使用MTX差异有统计学意义(P0.05)。多因素分析显示术前24 h内血β-hCG(OR=6.026,P=0.002),手术方式(OR=5.276,P=0.021),术中未切除黄体(OR=0.094,P=0.028)和未使用MTX(OR=0.179,P=0.026)是发生PEP的独立危险因素。结论腹腔镜保守性手术治疗输卵管妊娠安全、有效,术前血β-hCG值较高、手术方式不恰当、术中未切除黄体及未使用MTX的患者术后易发生PEP。     

Laparoscopic approach to incarcerated inguinal hernia

The safety and effectiveness of laparoscopic treatment for incarcerated inguinal hernia have not been clarified. Six patients who underwent laparoscopic reduction and repair of incarcerated inguinal hernias were reviewed retrospectively. All operations were initiated within 1 h after establishment of the diagnosis. Laparoscopically, the incarcerated small-bowel segments could be easily returned to the abdominal cavity by a combination of pulling them with Babcock forceps while pushing back the bowels from outside the abdominal wall. The hernial portals were not cut in three patients, while they were dissected in the other three. All incarcerated bowels were congested and red immediately after reduction; however, their color returned to normal during hernia repair and unnecessary bowel resection was therefore avoided. The mean operation time was 88 min. Although one patient underwent laparotomy because of the suspicion of necrosis of the incarcerated inguinal hernia, which was finally found to be due to postoperative paralytic ileus, the postoperative courses of the remaining five were uneventful. Laparoscopic reduction and repair of incarcerated inguinal hernia was useful, and unnecessary bowel resection could be avoided. Received: 9 February 1996/Accepted: 20 May 1996     

Inguinal hernia: Challenging the traditional indication for surgery in asymptomatic patients

Background: It is generally accepted that most inguinal hernias should be operated on electively in order to avoid the high morbidity and mortality associated with incarceration and small bowel obstruction. The present study reassesses the indication for surgery in asymptomatic inguinal hernia patients. Methods: We analyzed profiles, separately, for elective and emergency inguinal herniorrhaphies and compared the morbidity and mortality rates. Results: Two hundred randomly selected elective hernia repairs were compared with 67 incarcerated cases. Postoperative complications were more common following emergency (23.9%) than elective repair (10.5%); however, in both groups, minor complications predominated. The mortality rate in the incarcerated group (6%) was clearly linked with a high preoperative American Society of Anesthesiologists (ASA) score. A bowel resection rate of 4.5% was found in the incarcerated cases, which was not correlated with mortality. Conclusions: Patients with asymptomatic inguinal hernia and unfavorable medical conditions should be recommended an elective repair, preferably under local anesthesia, to avoid the high mortality associated with an emergency operation.     

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??Emergency operation strategies and treatment effect of incarcerated inguinal hernia in elderly patients: A report of 87 cases SUN Li, LIU Yu-chen, WANG Ming-gang. Department of Hernia and Abdominal Wall Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100043, China
Corresponding author: WANG Ming-gang, E-mail:wmgonly@126.com
Abstract Objective To discuss the emergency operation strategies and treatment effect of incarcerated inguinal hernia in elderly patients. Methods The clinical data of 87 emergency cases of elderly incarcerated inguinal hernia from January 2015 to April 2017 in Beijing Chao-Yang Hospital were analyzed retrospectively. The clinical data and complications were analyzed between laparoscopic group (12 cases) and open group (75 cases). Results Laparoscopic inguinal hernia repair were performed in 12 cases (laparoscopic group); In open group, open inguinal hernia repair were performed in 71 cases, and traditional repair were performed in 4 cases. The follow-up time was 11(10~14)months. Among 87 cases, 79 cases??90.8%?? finished follow-up,1 death case was observed during perioperative period. In open group, 1 intestinal fistula case was observed. No recurrent or chronic pain case was observed in both two groups. The difference of incidence of infection (Lap. 0 vs. Open 5.3%, P=0.000), hematomas (Lap. 0 vs. Open 14.7%, P=0.000), seroma after 1 month (Lap. 33.3% vs. Open 40.3%, P=0.012) , seroma after 3 month (Lap. 16.7% vs. Open 31.3%, P=0.024) and hospital stay [Lap. 5??4-6??d vs. Open 7??6-10??d, P=0.032] between two groups was statistically. Conclusion Emergency operation is important for incarcerated inguinal hernia of elderly after diagnosis. An individualized operative strategies is needed. General evaluation is important although laparoscopy has advantage in exploration.     

嵌顿性腹股沟疝的外科治疗策略

目的比较无张力疝修补术与传统修补术在嵌顿性腹股沟疝治疗中的利弊。方法回顾性分析2002年1月至2009年12月间收治的嵌顿性腹股沟疝70例,急诊手术分为两组：无张力疝补片修补术组（47例）,行疝环充填式无张力修补术（Rutkow）;传统疝修补手术组（23例）,行Bassini修补术。术前有腹膜炎体征、术前考虑为嵌顿疝而术中发现为绞窄疝者不在此研究之列。结果无张力手术组平均手术时间为（87±13）min,较传统手术组长（78±14）min;住院时间传统手术组（6．4±2．9）d稍高于无张力组（5．9±2．3）d;术后阴囊血肿的发生无张力组为8．5％（4例）,而在传统手术组仪4．3％（1例）,但以上结果差异均无统计学意义。两组患者术后均无切口感染病例。传统手术组术后应用止痛剂11例,而无张力组仅有2例,差异有统计学意义（P=0．001）。术后随访9～100个月,传统手术组复发率13％（3例）与无张力组（0例）相比差异有统计学意义（P=0．032）。结论在嵌顿性腹股沟疝的治疗中采用无张力疝修补术可以取得较好的效果,但术中的手术技巧和预防感染的措施,对防止手术并发症的作用值得重视。     

老年腹股沟嵌顿疝87例急诊手术疗效分析

目的 探讨老年腹股沟嵌顿疝的急诊手术选择和治疗效果。方法 回顾性分析2015年1月至2017年4月北京朝阳医院急诊手术的87例老年腹股沟嵌顿疝病人资料,分为腹腔镜组（12例）和开放组（75例）,分析病人的临床资料、手术方式选择及并发症发生率等。结果 腹腔镜组12例均行腹腔镜腹股沟疝修补手术;开放组75例病人中,71例行开放腹股沟疝修补术,4例行传统疝修补术。随访时间11（10~14）个月。79例（90.8%）病人完成随访,1例病人死亡。开放组出现肠瘘1例,两组病人均未出现复发、慢性疼痛等并发症。腹腔镜组和开放组的的感染发生率分别为0和5.3%（P=0.000）,血肿发生率分别为0和14.7%（P=0.000）,术后1个月血清肿发生率分别为33.3%（4/12） 和40.3%（27/67）（P=0.012）、术后 3个月血清肿发生率分别为16.7%（2/12）和 31.3%（21/67）（P=0.024）,住院时间分别为5（4~6）d和7（6~10）d（P=0.032）,差异均有统计学意义。结论 老年腹股沟嵌顿疝病人诊断明确后均应行急诊手术,手术策略与手术方式的选择应遵循个体化治疗的理念,尽管腹腔镜手术具有探查腹腔的优势,但应综合评估后慎重选择。     

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??Risk factors of surgical site infection after incarcerated inguinal hernia repair YANG Lin-hua, CHEN Tao, WANG Jian. Department of General Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127,China
Corresponding author: WANG Jian??E-mail ??dr_wangjian@yahoo.com.cn
Abstract Objective To investigate risk factors of surgical site infection after incarcerated inguinal hernia repair. Methods The clinical data and follow-up of 301 cases of incarcerated inguinal hernia repair performed from January 2005 to December 2010 in Renji Hospital, Shanghai Jiao Tong University were analyzed retrospectively. Cases of intestinal necrosis were excluded. Results All cases had short-term follow-up (3 month). There were 13 cases of postoperative complication including 1 case of localized hematoma??0.3%??, 8 cases of seroma ??2.7%??and 4 cases of superficial surgical site infection ??1.3%??. Diabetes??P=0.015??, incarcerated time ??P=0.005??and seroma ??P =0.000??were related to superficial surgical site infection in short-term follow-up and no mesh infection was found. Among 226 cases (75.1%) of long-term follow-up (6-72 months), neither surgical site infection nor mesh infection was found, except for 3 cases of hernia recurrences. Conclusion Surgical site infection rate in short-term is related to diabetes, incarcerated time (>24 hours) and seroma. Tension-free hernia repair is safe and feasible in incarcerated inguinal hernia.     

腹股沟嵌顿疝术后手术部位感染因素分析

目的 探讨引起腹股沟嵌顿疝手术部位感染的危险因素。方法 回顾性分析上海交通大学医学院附属仁济医院普外科2005年1月至2010年12月经手术治疗的301例腹股沟嵌顿疝病人的临床资料及随访结果,其中伴有绞窄坏死者予以剔除。结果 术后近期（3个月内）全部随访,术后发生伤口血肿1例（0.3%）,伤口积液8例（2.7%）,伤口感染4例（1.3%）,无深部补片感染,术后近期浅表切口手术部位感染与糖尿病（P=0.015）、嵌顿时间（P=0.005）、伤口积液（P=0.000）相关。远期随访病例226例,随访率75.1%,随访期6～72个月,平均随访时间34.2个月,3例复发,无伤口感染或深部补片感染。结论 腹股沟嵌顿疝术后近期切口手术部位感染的危险因素为合并糖尿病、嵌顿时间>24 h及切口积液;腹股沟嵌顿疝行无张力修补术是安全可行的。     

Retrocecal hernia preoperatively diagnosed by computed tomography: A case report

IntroductionRetrocecal hernia is a rare type of pericecal hernia. Because it is difficult to diagnose preoperatively, it is often treated with emergency operation.Case presentationAn 83-year-old male patient experienced sudden abdominal pain. Marked small bowel dilatation and intestinal obstruction were detected by abdominal computed tomography (CT). An enhanced CT scan also revealed a trapped cluster of small bowel loops behind the cecum and ascending colon. We preoperatively diagnosed small bowel ileus as a result of retrocecal hernia. After conservative therapy with a long intestinal tube, an emergency operation was performed. During the surgery, a portion of the ileum was found to be incarcerated in the retrocecal fossa. Intestinal resection was not necessary because the incarcerated ileum appeared viable, and the orifice to the hernia was opened. The patient was discharged without postoperative complications.DiscussionThe diagnosis of retrocecal hernia can often be confirmed intraoperatively. This disease is identified based on a minimal error in rotation with incarceration behind the cecum during the final phase of descent and fixation of the right colon or failure of cecal and retroperitoneal fixation. Early preoperative diagnosis is important to prevent intestinal ischemia, necrosis, and perforation and to reduce resection rates.ConclusionEarly preoperative diagnosis is important to avoid resection of the small intestine. CT scans are useful for preoperative diagnosis in case of retrocecal hernia.