PDF(Pubmed)
Abstract：
UNASSIGNED: Spigelian hernias are rare, constituting about 1-2 % of all abdominal wall hernias. They present clinically significant challenges due to their potential for incarceration and strangulation. This case report highlights a unique presentation of a Spigelian hernia involving sigmoid colon strangulation, emphasizing the critical need for awareness and timely intervention.
METHODS: A 60-year-old female with hypertension and diabetes presented with severe left abdominal pain, nausea, and vomiting. Examination revealed leukocytosis, neutrophilia, and signs of acute abdomen. CT imaging showed a complicated left lateral abdominal wall hernia containing the sigmoid colon. Surgical intervention included sigmoidectomy with colorectal anastomosis and hernia repair. Postoperative recovery was successful with subsequent elective ileostomy reversal.
UNASSIGNED: The rarity of Spigelian hernias and their atypical presentations can complicate diagnosis and management. This case was particularly challenging due to the strangulation of the sigmoid colon within the hernial sac. Surgical management was necessary to address the incarcerated bowel segment and prevent further complications. This case underscores the utility of CT scans in diagnosing complex cases and guiding surgical strategy.
CONCLUSIONS: Despite their rarity, Spigelian hernias carry significant risks of strangulation. Prompt diagnosis and treatment are essential to avoid severe complications. This case highlights the importance of including Spigelian hernia in the differential diagnosis for acute abdominal symptoms, especially when they are nonspecific.
METHODS: A 60-year-old female with hypertension and diabetes presented with severe left abdominal pain, nausea, and vomiting. Examination revealed leukocytosis, neutrophilia, and signs of acute abdomen. CT imaging showed a complicated left lateral abdominal wall hernia containing the sigmoid colon. Surgical intervention included sigmoidectomy with colorectal anastomosis and hernia repair. Postoperative recovery was successful with subsequent elective ileostomy reversal.
UNASSIGNED: The rarity of Spigelian hernias and their atypical presentations can complicate diagnosis and management. This case was particularly challenging due to the strangulation of the sigmoid colon within the hernial sac. Surgical management was necessary to address the incarcerated bowel segment and prevent further complications. This case underscores the utility of CT scans in diagnosing complex cases and guiding surgical strategy.
CONCLUSIONS: Despite their rarity, Spigelian hernias carry significant risks of strangulation. Prompt diagnosis and treatment are essential to avoid severe complications. This case highlights the importance of including Spigelian hernia in the differential diagnosis for acute abdominal symptoms, especially when they are nonspecific.
摘要：
■Spigelian疝罕见，约占所有腹壁疝的1-2％。由于它们可能被监禁和勒死，它们在临床上面临重大挑战。该病例报告强调了涉及乙状结肠绞窄的Spigelian疝的独特表现，强调意识和及时干预的迫切需要。
方法：一名患有高血压和糖尿病的60岁女性，表现为严重的左腹痛，恶心,和呕吐。检查显示白细胞增多,嗜中性粒细胞增多症,和急腹症的迹象。CT成像显示复杂的左外侧腹壁疝包含乙状结肠。手术干预包括乙状结肠切除术和结直肠吻合术和疝修补术。术后恢复成功，随后进行了选择性回肠造口术逆转。
■Spigelian疝的罕见性及其非典型表现会使诊断和治疗复杂化。由于乙状结肠在疝囊内的绞窄，这种情况特别具有挑战性。必须进行手术治疗以解决肠段嵌顿并防止进一步的并发症。此病例强调了CT扫描在诊断复杂病例和指导手术策略中的实用性。
结论：尽管它们很少，Spigelian疝具有严重的勒死风险。及时诊断和治疗对于避免严重并发症至关重要。该病例强调了在急性腹部症状的鉴别诊断中包括Spigelian疝的重要性，尤其是当它们是非特异性的时候。
方法：一名患有高血压和糖尿病的60岁女性，表现为严重的左腹痛，恶心,和呕吐。检查显示白细胞增多,嗜中性粒细胞增多症,和急腹症的迹象。CT成像显示复杂的左外侧腹壁疝包含乙状结肠。手术干预包括乙状结肠切除术和结直肠吻合术和疝修补术。术后恢复成功，随后进行了选择性回肠造口术逆转。
■Spigelian疝的罕见性及其非典型表现会使诊断和治疗复杂化。由于乙状结肠在疝囊内的绞窄，这种情况特别具有挑战性。必须进行手术治疗以解决肠段嵌顿并防止进一步的并发症。此病例强调了CT扫描在诊断复杂病例和指导手术策略中的实用性。
结论：尽管它们很少，Spigelian疝具有严重的勒死风险。及时诊断和治疗对于避免严重并发症至关重要。该病例强调了在急性腹部症状的鉴别诊断中包括Spigelian疝的重要性，尤其是当它们是非特异性的时候。
