ABSTRACT
Objetivo: Presentar un caso de quiste de Nuck de la región inguinal. Métodos: Paciente adolescente de 16 años con aumento de volumen en región inguinal derecha y presencia de dolor, cuadro clínico de una hernia inguinal atascada. Resultados: El hallazgo quirúrgico de la intervención resultó ser un quiste de la región inguinal y cuyo resultado de anatomía patológica reporta ser un quiste de Nuck. Conclusión: Se define como quiste de Nuck, o quiste del ligamento redondo, un divertículo del peritoneo parietal en el canal inguinal que acompaña al ligamento redondo en la mujer encontrándose en condiciones fisiológicas obliterado. Este se manifiesta como un aumento de volumen en la región inguinal,irreductible, que puede ir acompañado o no de dolor; a veces puede presentarse simulando una hernia inguinocrural incarcelada y es frecuente en niños, siendo su presencia en adolescente y mujeres adultas y de avanzada edad una entidad muy rara(AU)
Objective: To present a case of Nuck's cyst in the inguinal region. Methods: A 16-year female teenager with an increase of volume in the right inguinal region and presence of pain. Clinical symptoms of an incarcerated inguinal hernia. Results: Surgical finding at the intervention turned out to bea cyst of the inguinal region and the result of pathology reported to be a cyst of Nuck. Conclusion: It is defined as cyst of Nuck, or cyst of the round ligament, a diverticulum of the peritoneum in the inguinal canal accompanying the round ligament in women being in physiological conditions obliterated. This is manifested as an increase in volume in the inguinal region, irreducible, that can go with or without pain, and sometimes mimicking a hernia can occurs inguinocrural incarcerated and is common in children being its presence in adolescent and adult women and elderly a very rare(AU)
Subject(s)
Humans , Female , Adolescent , Adolescent , Cysts , Groin , Hernia, Inguinal , Pain , Pathology , Peritoneum , Round LigamentsABSTRACT
PURPOSE: Laparoscopic herniorrhaphy (LH) has an advantage for evaluating the viability of incarcerated bowel. In this retrospective study, we aimed to review the data for use of the TEP technique in treating incarcerated hernias in order to document the feasibility of the laparoscopic procedure. METHODS: During a 2-year period from January 2008 to December 2009, one surgeon (C.S) at our institution operated on 27 patients with acutely (n=3) or chronically (n=24) incarcerated hernia. Incarcerated hernias were divided into acute or chronic types arbitrarily, based on who had symptoms of acute abdominal pain and signs of intestinal obstruction. For acute cases, the TEP procedure was done following laparoscopic transperitoneal evaluation to assess viability of the incarcerated bowel. RESULTS: All patients except one having a femoral hernia were male. Mean age was 41 years old (range, 25~75). No case converted from a laparoscopic to an open procedure. Two acute incarcerated cases contained a segment of small bowel and the other contained small bowel and omentum. All acute cases were operated on successfully on an emergency basis by laparoscopic TEP repair. All chronic cases contained omentum without bowel. In one case of acute and seven cases of chronic type, a small inguinal incision was made to reduce hernia contents. No recurrence was noticed at a mean of 13 months of follow-up. CONCLUSION: If there is no entrapment of bowel in chronic incarcerated cases, the TEP procedure will be satisfactory. It may be reasonable, however, to evaluate viability of bowel transperitoneally before doing a TEP procedure in acute cases.
Subject(s)
Humans , Male , Abdominal Pain , Emergencies , Hernia , Hernia, Femoral , Hernia, Inguinal , Herniorrhaphy , Imidazoles , Intestinal Obstruction , Laparoscopy , Nitro Compounds , Omentum , Pyrazines , Recurrence , Retrospective StudiesABSTRACT
PURPOSE: Incarcerated inguinal hernia may have very unusual hernial sac contents. In this study we aim to present clinical characteristics about incarcerated inguinal hernia of the greater omentum. METHODS: We retrospectively analyzed hospital records of 643 adult patients who underwent inguinal hernia repair from November 2001 to January 2009. The age, sex, location, type, symptom duration, body mass index (BMI), comorbidity, type of anesthesia, operative time, postoperative hospital stay and complications were reviewed. RESULTS: Of the 643 cases, 18 cases were omental incarcerated inguinal hernia group (O group). Seventeen in 18 cases of O group were male patient (NS). In O group, 16 cases were indirect type and 2 cases were femoral type (P=0.021). Mean age was younger in O group than in non-omental incarcerated inguinal hernia group (N group) (P=0.017). Duration of symptom was longer (P=0.013), and body mass index (BMI) was larger in O group (P=0.042). Operative time was longer in O group than in N group (P=0.006). CONCLUSION: The patients with omental incarcerated inguinal hernia mostly had long durations of protruding mass without pain. In these patients, operation was relatively difficult due to severe adhesion between the hernial sac and greater omentum. In addition, operative time took approximately 10 minutes longer. Therefore, general and spinal anesthesia is more feasible than local anesthesia.