慢性不可复性上腹疝伴横结肠的巨大腹壁脓肿
Massive Abdominal Wall Abscess in a Chronic Irreducible Epigastric Hernia Containing the Transverse Colon.
摘要(中文译文)
上腹壁疝通常包含腹膜前脂肪，而横结肠受累则是一种极为罕见的临床情况。我们报告一例独特的病例：一名56岁患者表现为巨大的腹壁脓肿，并发于长期存在、不可还纳的上腹壁疝。通过计算机断层扫描（CT）进行的临床和影像学评估显示，慢性疝囊内含有横结肠，周围环绕大量液体积聚，无急性嵌顿或明显肠穿孔的证据。急诊手术干预证实疝囊内存在存活的横结肠。脓肿很可能是慢性炎症或亚临床微穿孔所致。手术包括彻底脓肿引流、清创、成功将横结肠还纳回腹腔，随后行筋膜一期修补。本病例强调，被忽视的、不可还纳的上腹壁疝即使在没有急性绞窄的情况下，也可导致严重的感染性并发症，需要高度的临床警惕和及时的手术干预。
Abstract
Epigastric hernias typically contain preperitoneal fat, while the involvement of the transverse colon is an exceptionally rare clinical entity. We report a unique case of a 56-year-old patient presenting with a massive abdominal wall abscess complicating a long-standing, irreducible epigastric hernia. Clinical and radiological evaluation via computed tomography (CT) revealed that the chronic hernia sac contained the transverse colon, surrounded by an extensive fluid collection, without evidence of acute incarceration or frank bowel perforation. Emergency surgical intervention confirmed the presence of a viable transverse colon within the sac. The abscess was likely the result of chronic inflammation or subclinical micro-perforations. The procedure involved thorough abscess drainage, debridement, and successful reduction of the transverse colon back into the peritoneal cavity, followed by primary fascia repair. This case emphasizes that neglected, irreducible epigastric hernias can lead to severe infectious complications even in the absence of acute strangulation, necessitating a high index of clinical suspicion and prompt surgical intervention.
如何引用
AMA
Ioannis Katsarelas, Mohammad Husamieh, Athanasios Polychronidis, Konstantinos Popotis, Periklis Dimasis. Massive Abdominal Wall Abscess in a Chronic Irreducible Epigastric Hernia Containing the Transverse Colon.. Cureus. 2026; doi:10.7759/cureus.108623.
APA
Ioannis Katsarelas, Mohammad Husamieh, Athanasios Polychronidis, Konstantinos Popotis, Periklis Dimasis (2026). Massive Abdominal Wall Abscess in a Chronic Irreducible Epigastric Hernia Containing the Transverse Colon.. Cureus. https://doi.org/10.7759/cureus.108623
GB/T 7714
Ioannis Katsarelas, Mohammad Husamieh, Athanasios Polychronidis, Konstantinos Popotis, Periklis Dimasis. Massive Abdominal Wall Abscess in a Chronic Irreducible Epigastric Hernia Containing the Transverse Colon.[J]. Cureus, 2026 doi:10.7759/cureus.108623.
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