[Diagnosis and treatment of Spigelian hernia].
Autor: | Louring-Andersen M; Kirurgisk Afdeling, Køge Sygehus, DK-4600 Køge, Denmark. louringandersen@gmail.com, Hjørne FP, Skovdal J, Bisgaard T |
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Jazyk: | dánština |
Zdroj: | Ugeskrift for laeger [Ugeskr Laeger] 2009 Nov 23; Vol. 171 (48), pp. 3518-22. |
Abstrakt: | Introduction: Spigelian hernia is a rare condition, which is frequently difficult to diagnose. This study describes our experience and we briefly discuss our findings in relation to the sparse literature. Material and Methods: Seven-year retrospective study (2000-2006) with prospective follow-up in a consecutive series of patients. Results: We identified a total of 12 patients with 13 spigelian hernias among 379 patients with ventral hernia (3.1%). Symptoms and clinical findings varied substantially between patients. Due to strangulation, four patients underwent acute operation and eight patients underwent elective operation (laparoscopic (n = 7); open (n = 1)). One patient was treated conservatively. After a median of 3.3 years (range 0.8 to 6.8 years) recurrence was found in one patient and one patient (without recurrence) had moderate pain at the former hernia site. Discussion: Due to the relatively high risk of strangulation, all patients with spigelian hernias should be offered surgery regardless of symptoms. Pain and perhaps bulging at the semilunar line indicates a spigelian hernia, but the diagnosis can be difficult to establish. When in doubt, we suggest the use of computed tomography and, subsequently, diagnostic laparoscopy and laparoscopic repair. |
Databáze: | MEDLINE |
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