A CLINICAL STUDY OF SIX CASES OF INTERNAL HERNIA

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  • 内ヘルニア６例の検討

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We report a clinical study of six cases of internal hernia experienced at the hospital in a recent 20-year period. There were three cases of periduodenal hernia and each one case of hiatal hernia of the small bowel mesentery, subcecal fossa hernia, and hernia of the sigmoid mesentery, respectively. These patients were from 18 to 79 years old, with a mean of 58.0. The male-to-female ratio was 4 to 2. Ileus symptoms were noted in three out of the six cases, while no ileus symptoms appeared in three cases of periduodenal hernia. All six cases were diagnosed at laparotomy for colonic cancer. Preoperative diagnosis could not be made in all six cases, but imaging findings suggestive of internal hernia were visualized in five of six cases in which CT scanning was carried out before surgery. Operative procedures included reduction of the herniated intestine in all six cases and intestinal resection in two cases in which intestinal necrosis was noted. Hernia sac was closed in two cases and was kept open in one; the sacdisappeared by intestinal resection in the three periduodenal hernia. The prognosis was favorable in all cases.<br>It is thought that preoperative diagnosis of internal hernia is difficult, but we must keep the possibility of the disease in mind in carrying out imaging methods such as CT.

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