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Stellenwert des Pneumoperitoneums beim chirurgischen Management einer monströsen Skrotalhernie

Pneumoperitoneum in surgical management of giant scrotal hernias

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Zusammenfassung

Die chirurgische Therapie einer chronischen monströsen Abdominalhernie bedingt die Reposition des Bruchinhaltes und den spannungsfreien Bauchdeckenverschluss. Eine initiale Laparoskopie simuliert die postoperative Bauchwandspannung. Die Kenntnis und die Bedeutung des präoperativen Pneumoperitoneums bei chronischer Eventeration kann im Zeitalter der allgemein verfügbaren Laparoskopie eine „abdominelle Katastrophe“ mit Darmresektion, Abdominalkompartement oder aufwendiger Bauchdeckenplastik vermeiden. Wir berichten über den Fall einer langjährigen monströsen Skrotalhernie mit akuter Urosepsis bei Harnverhalt.

Abstract

Surgical treatment of giant abdominal hernias includes reduction of the hernia content and tension-free closure of the abdominal wall. Initial laparoscopy simulates the postoperative abdominal wall tension. Recognizing the need for a preoperative pneumoperitoneum in cases of chronic eventration may help to avoid “abdominal catastrophes” including bowel resection, abdominal compartment, and extended abdominal wall reconstruction. We report a 66-year-old man with an asymptomatic long-standing giant scrotal hernia who was admitted with sepsis and uremia caused by intestinal obstruction.

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Authors and Affiliations

  1. Allgemein-, Viszeral- und Gefäßchirurgie mit Departement Kinderchirurgie, Klinikum Kempten

    S. Limmer, T. Miksch, M. Fiederer & P. Sterk

  2. Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Chirurgie, Ratzeburger Allee 160, 23538, Lübeck

    S. Limmer

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  1. S. Limmer
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  2. T. Miksch
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  3. M. Fiederer
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  4. P. Sterk
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Correspondence to S. Limmer.

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Limmer, S., Miksch, T., Fiederer, M. et al. Stellenwert des Pneumoperitoneums beim chirurgischen Management einer monströsen Skrotalhernie. Chirurg 77, 257–262 (2006). https://doi.org/10.1007/s00104-005-1104-0

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  • DOI: https://doi.org/10.1007/s00104-005-1104-0

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