TY - JOUR
T1 - Clinical spectrum of internal hernia
T2 - A surgical emergency
AU - Fan, Hsiu Ping
AU - Yang, Albert D.
AU - Chang, Yu Jun
AU - Juan, Chi Wen
AU - Wu, Han Ping
PY - 2008/10
Y1 - 2008/10
N2 - Purpose. To define the indicators of bowel ischemia caused by congenital or acquired internal hernia, based on our 10-year experience in one center. Methods. We reviewed the medical records, imaging studies, and operative findings of 20 patients who underwent surgery for an internal hernia at our medical center between 1995 and 2005. The clinical characteristics and related indicators of the patients with, and those without bowel ischemia were compared and analyzed statistically. Results. The subtypes of congenital internal hernia (CIH) included transmesenteric (n = 6, 60%), paraduodenal (n = 2, 20%), and pericecal (n = 2, 20%) hernia. The abdominal surgical procedures preceding acquired internal hernia (AIH) were Roux-en-Y anastomosis (n = 6, 60%) and appendectomy (n = 3, 30%). Transmesenteric hernia was the most prevalent type of CIH in children. Abdominal rebound tenderness, advanced leukocytosis (>18 000/mm3), or a high level of manual band form (>6%) were the positive predictive factors for bowel ischemia, whereas a history of chronic intermittent abdominal pain was a negative indicator. No recurrence was noted during the 10-year study period. The overall mortality rate was 20%, attributable to enteral bacteria sepsis in all cases. Conclusion. Internal hernia is a rare but lethal condition. Early diagnosis and prompt surgical intervention provide the only chance of a successful outcome.
AB - Purpose. To define the indicators of bowel ischemia caused by congenital or acquired internal hernia, based on our 10-year experience in one center. Methods. We reviewed the medical records, imaging studies, and operative findings of 20 patients who underwent surgery for an internal hernia at our medical center between 1995 and 2005. The clinical characteristics and related indicators of the patients with, and those without bowel ischemia were compared and analyzed statistically. Results. The subtypes of congenital internal hernia (CIH) included transmesenteric (n = 6, 60%), paraduodenal (n = 2, 20%), and pericecal (n = 2, 20%) hernia. The abdominal surgical procedures preceding acquired internal hernia (AIH) were Roux-en-Y anastomosis (n = 6, 60%) and appendectomy (n = 3, 30%). Transmesenteric hernia was the most prevalent type of CIH in children. Abdominal rebound tenderness, advanced leukocytosis (>18 000/mm3), or a high level of manual band form (>6%) were the positive predictive factors for bowel ischemia, whereas a history of chronic intermittent abdominal pain was a negative indicator. No recurrence was noted during the 10-year study period. The overall mortality rate was 20%, attributable to enteral bacteria sepsis in all cases. Conclusion. Internal hernia is a rare but lethal condition. Early diagnosis and prompt surgical intervention provide the only chance of a successful outcome.
KW - Bowel ischemia
KW - Indicator
KW - Internal hernia
KW - Small-bowel obstruction
UR - http://www.scopus.com/inward/record.url?scp=52949140206&partnerID=8YFLogxK
U2 - 10.1007/s00595-007-3756-5
DO - 10.1007/s00595-007-3756-5
M3 - 文章
C2 - 18820864
AN - SCOPUS:52949140206
SN - 0941-1291
VL - 38
SP - 899
EP - 904
JO - Surgery Today
JF - Surgery Today
IS - 10
ER -