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| 篇名 |
Obturator Hernia: The Experience of Kaohsiung Veterans General Hospital |
| 作者 |
Wen-Ching Kung, Shiuh-Inn Liu, Nan-Hua Chou, Cheng-Chung Tsai, Being-Whey Wang,I-Shu Chen, Ming-Sing Ye, Yu-Chia Chen, King-Tong Mok |
| 卷期/出版年月 |
37卷3期 (2004/6) |
| 頁次 |
112-117 |
| 摘要 |
Objective: Obturator hernia is a rare internal hernia but it represents an
important cause of intestinal obstruction in elderly women. The aim of the present retrospective review is to report our experience with a view to identify clinical features that help in earlier diagnosis and treatment.
Patients and Methods: Nine patients with intestinal obstruction due to obturator
hernia were treated in the Kaohsiung Veterans General Hospital between June,
1993 and June, 2002. The clinical records of these nine patients were reviewed.
Results: One male and eight females were enrolled in this study. The median age
was 79 years old. All presented with the symptoms of small bowel obstruction.
Clinical signs such as Howship-Romberg sign and palpable groin mass were found
in only one patient. Abdominal computerized tomography scan (abdominal CT
scan) was performed in seven patients and four of them had a correct pre-operative diagnosis. All of the nine patients received surgical intervention on the admission day or the following day. Bowel resection was performed in seven patients (78%) including one delayed bowel perforation. The duration of symptoms prior to hospital visit ranged from four hours to six days with a median of 48 hours. The length of hospitalization ranged from 7 to 48 days with a median of 29 days. All nine patients survived.
Conclusions: A high index of suspicion is essential to the diagnosis in the case of an elderly woman with symptoms of small bowel obstruction but without previous abdominal operation. Abdominal CT may be a useful diagnostic tool. Patients with pre-operative accurate diagnosis had a shorter hospital stay and decreased postoperative complication in our series. Awareness of this disease and early treatments are the key to reduction in associated morbidity and mortality. |
| 關鍵詞 |
obturator hernia, intestinal obstruction, abdominal CT scan |
| 分類 |
Original Articles |
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