隐匿性腹股沟斜疝60例诊断和治疗

目的 提高对隐匿性腹股沟斜疝的诊断与治疗水平。方法 对不明原因的腹股沟区疼痛患，初期高度怀疑为隐匿性腹股沟斜疝时即行手术探查；近期采用疝囊造影术明确诊断后再行手术治疗。手术方法分别采用疝囊高位结扎术、张力性疝修补术和无张力疝修补术。结果 初期手术探查4_4例，明确诊断并手术治疗4l例。误诊而致阴性探查3例，术后2例5年内复发再手术；近五年对30例施行了疝囊造影术，术前确诊19例，均由手术证实，无l例假阳性。术后患症状消失，恢复良好。尚无复发。结论 疝囊造影术可提高对隐匿性腹股沟斜疝的术前诊断水平，避免手术探查盲目性。

Diagnosis and treatment of occult indirect inguinal hernia (A report of 60 cases)

Ojective To enhance the ability of diagnosis and therapy for occult indirect inguinal hernia. Methods Surgical exploration was performed for patients highly suspected with occult indirect inguinal hernia based on clinical manifestations and physical examinations in the initial stage. At present, herniography was used to confirm the diagnosis. High ligation of the hernial sac, non-mesh methods of open groin hernia repair or tension-free inguinal hernia repair was performed for the patients. Results Forty-four cases were given surgical exploration in the initial stage and 41 cases were confirmed and treated by operation. Misdiagnosis was found in 3 cases and surgical exploration revealed no sign of disease. Relapse occurred in two cases within 5 years. Nineteen out of 30 patients were confirmed by herniography in the last five years and operated on. There was no false-positive herniogram in this series. Follow-up evaluation of the patients showed disappearance of preoperative symptoms. Groin hernia has not recurred so far. Conclusions The ability of diagnosis for occult indirect inguinal hernia can be enhanced by herniography. Blind surgical exploration can be reduced. Herniography is a safe, reliable and practical diagnostic procedure.