PDF(Pubmed)
Abstract：
External supravesical hernias with ovarian incarceration have not been reported previously. Here, we describe transabdominal preperitoneal (TAPP) repair of an external supravesical hernia with ovarian incarceration. A 68-year-old woman presented to our outpatient clinic with the chief complaint of right inguinal swelling and pain. A 3-cm-diameter mass in the right inguinal region that was difficult to reduce was palpable, and computed tomography (CT) revealed a suspicious lesion of the right hydrocele of the canal of Nuck. Hydrocelectomy was performed through an inguinal incision, and the external inguinal ring was repaired using the Marcy method. The histopathological examination confirmed the diagnosis of the canal of Nuck. Three months postoperatively, the patient again presented with right inguinal pain, and CT revealed a right femoral hernia requiring surgical repair. Intraoperative findings revealed a right external supravesical hernia with an incarcerated ovary, which was laparoscopically reduced and repaired with a mesh. At the three-month follow-up, there were no postoperative complications or recurrences. Incarcerated ovaries with inguinal hernias have been reported in girls; however, incarcerated ovaries with external supravesical hernias have not been reported in women. Although the preoperative diagnosis was difficult to make in this case, the laparoscopic approach led to the diagnosis and successful mesh repair. Although optimal mesh repair of external supravesical hernias using TAPP has not been established, we believe that 2-5 cm around the hernial orifice, the Hesselbach triangle, and the lateral triangle should be covered with mesh.
摘要：
先前尚未报道过卵巢嵌顿的膀胱上疝。这里,我们描述了经腹腹膜前（TAPP）修补卵巢嵌顿的膀胱上疝。一名68岁的妇女出现在我们的门诊诊所，主要主诉右腹股沟肿胀和疼痛。右侧腹股沟区直径3厘米的肿块难以缩小，计算机断层扫描（CT）显示Nuck管右鞘膜积液可疑病变。通过腹股沟切口行房孔切除术，并用Marcy方法修复了腹股沟外环。组织病理学检查证实了Nuck管的诊断。术后三个月,患者再次出现右侧腹股沟疼痛，CT显示右股疝需要手术修复.术中发现右膀胱上疝伴卵巢嵌顿，腹腔镜缩小并用网片修复。在三个月的随访中，术后无并发症或复发.据报道，女孩患有腹股沟疝的卵巢嵌顿；然而，女性未报告卵巢嵌顿合并膀胱上疝。尽管在这种情况下术前诊断很困难，腹腔镜方法导致诊断和成功的网状修复。尽管尚未确定使用TAPP进行膀胱上疝的最佳网状修复，我们认为在疝孔周围2-5厘米，Hesselbach三角形,横向三角形应该用网格覆盖。
