31例腹内疝临床分析

目的分析腹内疝的发病原因及诊断与治疗方案.方法回顾性分析自1977年2月至2001年12月手术治疗的腹内疝31例,其中男26例,女5例;年龄16～25岁4例,26～40岁6例,41～55岁19例,56岁以上2例.结果先天性腹内疝与胚胎发育期中肠的旋转与固定不正常及肠转位时脏层与壁层腹膜愈接不全或肠系膜的部分退化或薄弱有关;后天性腹内疝与手术或外伤有关.结论对有间歇性或发作性腹痛史,腹部触及腊肠状压痛性肿块,X线显示肠梗阻征,选择性动脉造影提示小肠动脉弓走行移位者,应考虑腹内疝的诊断并及时剖腹探查.在使肠曲复位和修补疝颈或裂孔时,不可损伤肠系膜上动脉等重要血管.

Clinical analysis of 31 cases of intra-abdominal hernia

Objective To analyze the causes and the scheme of diagnosis and treatment of intra abdominal hernia. Methods Clinical data from 31 cases of intra abdominal hernia from 1977 to 2001 were analyzed retrospectively. Among the patients were 26 male and 5 female, and 4, 6, 19, and 2 patients were at the age range of 16 25, 26 40, 41 55, and over 56 years old, respectively. Results The causes of congenital intra abdominal hernia were related to malrotation of intestine and abnormality of intestine fixation during embryogenesis, to erroneous juncture of visceral layer peritoneum with parietal peritoneum, and to partial degeneration and weakness of mesentery. The causes of acquired intra abdominal hernia were related to operation or trauma. Conclusion As to patients with intermittence or episode of stomachache, touched painful sausage like mass, intestinal obstruction by X ray, and displacement of aortic arch of small intestines shown by selective arteriography, diagnosis of intra abdominal hernia and immediate operation should be considered. When reduction of the twisted intestines and repair of the hernial neck or hiatus are performed, important blood vessels such as the superior mesenteric arteries should not be injured.