| 篇名 |
Strangulated Epigastric Hernia Mimicking Abdominal Wall Carbuncle: Report of a Case |
| 作者 |
Hsien Liu, Chih-Kun Huang, Po-Chin Yu, Pei-Min Hsieh, Chao-Ming Hung, Yaw-Sen Chen |
| 卷期/出版年月 |
42卷4期 (2009/8) |
| 頁次 |
219-223 |
| 摘要 |
Epigastric hernias occur secondary to herniation via linea alba fascial defects and
are clinically uncommon. They are diagnostically challenging to primary care
physicians because of their low incidence. Epigastric hernias should be rapidly
diagnosed and treated, because their serious complications include bowel
incarceration. We herein report a 61-year-old female patient with a strangulated
epigastric hernia on clinical presentation. The hernia mimicked a large abdominal
wall carbuncle. Further imaging studies confirmed the diagnosis of incarcerated
epigastric hernia. In emergent laparotomy, the defect in the linea alba measured 3
cm in diameter and a strangulated small bowel segment which measured 18 cm in
length was found inside the hernia sac. Segmental resection of the necrotic small
bowel was performed with end-to-end anastomosis. The fascial defect was closed
with interrupted sutures. The patient had an uneventful postoperative recovery. No
hernia recurrence was noted after 4 years of follow-up. The detailed clinical history
and thorough physical examination allowed us to make a differential diagnosis list
for all causes of protruding masses along the linea alba. Accordingly, epigastric
hernias should always be considered as an important possibility in patients with
appropriate clinical signs. |
| 關鍵詞 |
hernias, epigastric hernia, abdominal wall |
| 分類 |
Case Report |
