其他疾病误诊为腹股沟疝的临床分析  

Clinical Analysis of Other Diseases Misdiagnosed as Inguinal Hernia

作　　者：洪翼兮 章世海[2] HONG Yixi;ZHANG Shihai(Department of General Surgery,Jiangsu Provincial Second Chinese Medicine Hospital,Nanjing 210017,China;Department of General Surgery,Nanjing Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing 210014,China)

机构地区：[1]江苏省第二中医院普外科,南京210017 [2]南京市中西医结合医院普外科,南京210014

出　　处：《临床误诊误治》2023年第3期10-14,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的 分析腹股沟疝的临床特点、误诊原因,并总结防范措施。方法 回顾性分析2017年8月—2021年7月3例于入院初期误诊为腹股沟疝的临床资料。结果 本组1例左侧阴囊肿痛,1例右侧腹股沟包块,1例突发左下腹疼痛。3例均有相似的临床症状,行B超检查,初诊皆误诊为腹股沟疝。误诊时间为2 h~15 d。1例经专科会诊后考虑精索扭转,经手术治疗后恢复良好;1例第3次住院穿刺活检考虑右侧腹股沟肿物(见异型细胞),目前随访中;1例经术中探查考虑小肠穿孔,经手术治疗后恢复良好。结论 患者以腹股沟包块、疼痛等类似腹股沟疝表现就诊时,需考虑其他相关疾病的可能,临床医师应熟练掌握腹股沟疝的诊断及鉴别诊断,详细询问病史,尽早完善相关检查,提高诊断准确率,避免误诊。Objective To analyze the clinical characteristics and causes of misdiagnosis of inguinal hernia,and to summarize the preventive measures of misdiagnosis.Methods The clinical data of 3 cases misdiagnosed as inguinal hernia at early stage of admission between August 2017 to July 2021 was retrospectively analyzed.Results In this group,there was 1 case of left scrotal swelling pain,1 case of right groin mass,1 case of sudden left lower abdominal pain.All the 3 cases had similar clinical symptoms and were misdiagnosed as inguinal hernia by B-ultrasound.Misdiagnosis lasted from 2 h to 15 d.One case was considered to be torsion of spermatic cord after specialist consultation and recovered well after surgical treatment.After biopsy,1 patient was considered as right inguinal mass(xenotypic cells could be seen)by biopsy during hospitalization for the third time,and was under follow-up.One case was considered as having perforation of small intestine through intraoperative exploration,and recovered well after surgical treatment.Conclusion When patients present with inguinal mass,pain and other similar manifestations of inguinal hernia,the possibility of other related diseases should be considered.Clinicians should be proficient in the diagnosis and differential diagnosis of inguinal hernia,inquire about the detailed medical history,perform relevant examinations as soon as possible,improve the diagnostic accuracy and avoid misdiagnosis.

关 键 词：精索扭转 腹股沟肿物 小肠穿孔 误诊 腹股沟疝 

分 类 号：R691.6[医药卫生—泌尿科学] R656.21[医药卫生—外科学]