腹外疝影像学诊断精编版.pptVIP

—Compression of femoral vein on CT scans through acetabula and pubic symphysis in 66-year-old woman. Suzuki S et al. AJR 2007;189:W78-W83 ?2007 by American Roentgen Ray Society 股疝 股疝 腹股沟韧带 腹股沟区疝鉴别诊断 斜疝 直疝 发生率 94% 6% 好发年龄 儿童及青壮年 老年 突出路径 经腹股沟管突出 经Hesselbach三角突出 疝块外形 椭圆形或梨形，基底细 半球形，基底宽 疝内容物还纳后压迫内环 疝块不突出 疝块仍突出 疝囊和精囊的关系 精索在疝囊后方 精索在疝囊前外侧 疝囊颈和腹壁下动脉的关系 疝囊颈在其外侧 疝囊颈在其内侧 嵌顿情况 易 不易 上述腹外疝鉴别诊断 腹股沟疝 闭孔疝 股疝 疝块位置 腹股沟韧带上方，耻骨结节内上 耻骨肌、闭孔外肌间 腹股沟韧带下方，耻骨结节外下 股静脉受压 很少见 — 很常见 与精索关系 斜疝与精索紧密相邻 — 反之 突出路径 经腹股沟管或Hesselbach三角 经闭孔管于耻骨肌深层、股三角的下端突出 经股管疝入，并于股静脉内侧的卵圆窝突出 谢谢大家 参考文献 [1] Aguirre D A, Santosa A C, Casola G, et al. Abdominal wall hernias: imaging features, complications, and diagnostic pitfalls at multi-detector row CT[J]. Radiographics,2005,25(6):1501-1520. [2] Suzuki S, Furui S, Okinaga K, et al. Differentiation of femoral versus inguinal hernia: CT findings[J]. AJR Am J Roentgenol,2007,189(2):W78-W83. [3] Toms A P, Dixon A K, Murphy J M, et al. Illustrated review of new imaging techniques in the diagnosis of abdominal wall hernias[J]. Br J Surg,1999,86(10):1243-1249. [4] Shadbolt C L, Heinze S B, Dietrich R B. Imaging of groin masses: inguinal anatomy and pathologic conditions revisited[J]. Radiographics,2001,21 Spec No:S261-S271. [5] Robinson P, White L M, Agur A, et al. Obturator externus bursa: anatomic origin and MR imaging features of pathologic involvement[J]. Radiology,2003,228(1):230-234. [6] Bhosale P R, Patnana M, Viswanathan C, et al. The inguinal canal: anatomy and imaging features of common and uncommon masses[J]. Radiographics,2008,28(3):819-835, 913. [7] Yoon W, Kim J K, Jeong Y Y, et al. Pelvic arterial hemorrhage in patients with pelvic fractures: detection with contrast-enhanced CT[J]. Radiographics,2004,24(6):1591-1605, 1605-1606. [8] Zhang H, Cong J C, Chen C S. Ileum perforation due to delayed operation in obturator hernia: a case report and review of literatures[J]. World J Gastroenterol,2010,16(1):126-130. [9] Cherian P T, Parnell A P. The diagnosis and