A RARE CASE OF HERNIA BURSAE IN WHICH MULTISLICE CT WAS USEFUL IN DIAGNOSIS

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  • ＭＤＣＴが術前診断に有効であった網嚢ヘルニアの１例

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Abstract

A 40-year-old woman was admitted to the hospital because of gradually intensifying abdominal pain and vomiting after lunch. The patient had no previous history of undergoing abdominal surgery. An abdominal multi-row detector CT (MD-CT) scan showed the presence of the small intestine behind the stomach and liver. Hernia bursae was thus diagnosed. A long tube was placed in expectation of spontaneous reduction of the hernia, but the treatment was unsuccessful. On the next day an emergency operation was performed. Operation findings showed that the small intestine about 60cm in length was herniated into the fusion between the omentum and transverse colon without a hiatus. We reduced the incarcerated ileum manually. No intestinal resection was needed, since the herniated bowel was viable. <BR>Hernia bursae without hiatus like this case is rare, but we must keep it in mind as a pathologic condition causing ileus symptoms in patients without history of laparotomy.<BR>Multiplanar reformation images (MPR) obtained with MD-CT were very useful in making early diagnosis preoperatively.

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