Indirect inguinal hernia containing portosystemic shunt vessel: A case report  

作　　者：Masahiro Yura Kikuo Yo Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko Hiroto Fujisaki AkiraHirata Kiminori Takano Kumiko Hongo Kimiyasu Yoneyama Motohito Nakagawa 

机构地区：[1]Department of Surgery,Hiratsuka City Hospital,Hiratsuka 2540065,Kanagawa,Japan

出　　处：《World Journal of Clinical Cases》2021年第2期509-515,共7页世界临床病例杂志

摘　　要：BACKGROUND Inguinal hernia repair is one of the most common general surgical operations worldwide.We present a case of indirect inguinal hernia containing an expanded portosystemic shunt vessel.CASE SUMMARY We report a 72-year-old man who had a 4 cm×4 cm swelling in the right inguinal region,which disappeared with light manual pressure.Abdominal-pelvic computed tomography(CT)revealed a right inguinal hernia containing an expanded portosystemic shunt vessel,which had been noted for 7 years due to liver cirrhosis.We performed Lichtenstein’s herniorrhaphy and identified the hernia sac as being indirect and the shunt vessel existing in the extraperitoneal cavity through the internal inguinal ring.Then,we found two short branches between the expanded shunt vessel and testicular vein in the middle part of the inguinal canal and cut these branches to allow the shunt vessel to return to the extraperitoneal cavity of the abdomen.The hernia sac was returned as well.We encountered no intraoperative complications.After discharge,groin seroma requiring puncture at the outpatient clinic was observed.CONCLUSION If an inguinal hernia patient has portal hypertension,ultrasound should be used to determine the contents of the hernia.When atypical vessels are visualized,they may be shunt vessels and additional CT is recommended to ensure the selection of an adequate approach for safe hernia repair.

关 键 词：Inguinal hernia Lichtenstein’s herniorrhaphy Portosystemic shunt Portal hypertension Shunt vessel Case report 

分 类 号：R656.21[医药卫生—外科学]