闭孔疝早期诊断和外科治疗

目的探讨闭孔疝的早期诊断，以及开放式全腹膜外疝修补术在闭孔疝治疗中的应用。方法回顾性分析2000年1月至2013年6月，浙江大学医学院附属第二医院收治的4例闭孔疝患者的临床资料，分析、讨论其病例特点。结果4例闭孔疝患者，术前皆行CT检查，明确闭孔疝诊断。其中3例因肠梗阻急诊人院，并急诊行剖腹探查术，术中发现肠管坏死而行肠切除，单纯修补闭孔缺损；另1例患者，因左下肢痛入院，择期行开放式全腹膜外疝修补术，术后恢复良好。结论对于能早期诊断的闭孔疝患者，开放式全腹膜外疝修补术是一种安全、有效的手术方法。

Early diagnosis and surgical treatment of obturator hernia

Objective To investigate the early diagnosis and surgical treatment of obturator hernia, and to describe open totally extraperitoneal hernia repair for obturator hernia. Methods A retrospective analysis was conducted on four patients with obturator hernia who were admitted to The Second Affiliated Hospital of Zhejiang University School of Medicine from January 2000 to June 2013. Results All the four cases of obturator hernia were diagnosed by preoperative CT scan. Three of them were admitted due to intestinal obstruction and underwent emergency laparotomy. The intestinal resection and simple close of obturator defect were performed because of bowel necrosis. The other one was admitted with pain in the left lower limb. After the elective open totally extraperitoneal hernia repair, the patient showed a successful recovery. Conclusion The open totally extraperitoneal hernia repair has shown to be a safe and effective surgical method for the patients with obturator hernia if early diagnosed.