92岁老翁巨大腹壁疝 腹腔镜下修补成功The 92-year-old man was successful in laparoscopic repair of a huge abdominal hernia.转载2008-06-08

一个自报70岁(实际92岁)的老头来到北京安太医院，患双侧腹股沟斜疝20多年，阴囊有40多厘米，直立拖到膝盖上，像个篮球，几乎全部肠管和大网都在阴囊，腹部特别空虚，这种情况多能引起医生的唏嘘，还并发有慢性肺气肿，经常咳嗽。所以没有医生敢为其手术。老人生活及其困难。An old man who reported 70 years old(actually 92 years old) came to Beijing Antai Hospital and suffered from bilateral inguinal hernia for more than 20 years. The scrotum was more than 40 centimeters. It stood upright on the knee and was like a basketball. Almost all intestines and large nets are in the scrotum. The abdomen is particularly empty. This situation can cause doctors to cry, but also with chronic emphysema, often cough. So no doctor dares to operate on it. The old man's life and its difficulties.

安太医生急病人所急，想病人所想，在充分知情同意的前提下，冒风险为患者实施了腹腔镜下疝囊高位修补，疝内容还纳后，先利用补片将疝囊内口封堵，然后将耻骨疏韧带和腹股沟联合腱缝合。术后效果非常好，10天痊愈出院。Doctor Antai's urgent patient wanted the patient to think that under the premise of full informed consent, he took the risk of performing laparoscopic high repair of the hernia sac. After the content of the hernia was returned, he used the patch to seal the inside of the hernia sac. The pubic weaning band and the inguinal joint tendon are then sutured. The postoperative effect was very good and he was discharged after 10 days.

出院30多天，左下腹部却出现了大包，经过检查确诊为：腹壁疝。这是为什么呢?因为20多年来腹壁废用性萎缩，腹壁及其薄弱，加上隐瞒年龄，疝囊内容还纳后，腹压增加，肠管从下腹部最薄弱处凸出，形成了腹壁疝。无奈经过开腹再次用补片修补了腹壁薄弱处。After being discharged from the hospital for more than 30 days, a large bag appeared in the lower left abdomen. After examination, it was diagnosed as: abdominal wall hernia. Why is that? Because of the atrophy of the abdominal wall for more than 20 years, the abdominal wall and its weakness, coupled with the concealment of age, the content of the hernia sac has been added, the abdominal pressure has increased, and the intestine has protruded from the weakest part of the lower abdomen, forming abdominal wall hernia. Helplessly after opening the abdomen again repaired the weak area of the abdominal wall with a patch.

教训：注意核实患者年龄;同时加固腹壁薄弱处。

Lesson: Pay attention to verifying the patient's age; At the same time reinforce the weak area of the abdominal wall.