Diagnosis and treatment of nine elderly patients with incarcerated extracorporeal hernia combined with colorectal cancer / 中国医师进修杂志

ABSTRACT

Objective To investigate the clinical features, diagnosis and treatment of colorectal cancer in patients with incarcerated extracorporeal hernia. Methods The clinical manifestations, diagnosis and treatment of 9 cases of incarcerated hernias combined with colorectal cancer from January 2012 to December 2017 were retrospectively analyzed. Results All the patients were treated with surgery. Three cases underwent Hartmann surgery and incarcerated release, high ligation of hernia sac; 2 cases underwent tumor resection and tension-free hernia repair; 1 case underwent necrotic bowel resection, tumor resection and ileal stoma and tension-free hernia repair; 1 case underwent transverse colostomy and incarcerated release, high cyst ligation; 1 case underwent tension-free hernia repair and limited colon cancer radical resection; 1 case underwent high ligation of the hernia sac and limited tumor resection. Intraoperative and postoperative pathology confirmed that this group was all incarcerated abdominal hernia combined with colorectal cancer. There were 4 patients misdiagnosed before surgery. Conclusions The diagnosis and treatment often ignore the presence of colorectal cancer due to the typical clinical manifestations of incarcerated abdominal hernia. The preoperative misdiagnosis rate is high. Completing CT scans before surgery can help clarify the diagnosis and select a reasonable surgical approach.