Детская хирургия. Журнал им. Ю.Ф. Исакова. 2023; 27: 304-316
Грыжа спигилиевой линии у детей: клинический пример и мета-анализ данных литературы
https://doi.org/10.55308/1560-9510-2023-27-4-304-316Аннотация
Введение. Грыжа спигелиевой или полулунной линии (ГСЛ) – крайне редкое заболевание для педиатрической практики. Несмотря на то что в основном оно имеет врождённый характер, выявление и, следовательно, его хирургическая коррекция в основном приходится на возраст старше 50 лет.
Клиническое наблюдение. В АО «Ильинская больница» проведено хирургическое лечение девочки 6 мес. Ребёнок с рождения наблюдался по поводу терминального гидронефроза, осложнённого разрывом собирательной системы почки. В возрасте 4 мес в связи с отсутствием функции и рецидивирующей инфекцией мочевыделительной системы ребёнку была выполнена нефруретерэктомия. На 4-е сутки после операции у ребёнка отмечено беспокойство, болевой синдром. По данным ультразвукового исследования (УЗИ), выявлена ущемлённая ГСЛ справа. Под контролем УЗИ выполнено вправление грыжи. При динамическом наблюдении повторных эпизодов ущемления не было. В возрасте 6 мес ребёнку выполнена лапароскопическая пластика ГСЛ справа местными тканями. Послеоперационный период протекал гладко. Наблюдение в течение 3 мес не выявило признаков рецидива ГСЛ.
Заключение. Анализ источников литературы показал, что в мире описано 95 случаев ГСЛ у детей за период около 90 лет. В статье представлены прямые и косвенные признаки наличия ГСЛ, возможные осложнения и варианты хирургического лечения. Лапароскопическая коррекция ГСЛ выполнена всего в 4 наблюдениях в возрасте от 11 мес. Наше наблюдение является пятым случаем лапароскопической коррекции ГСЛ, описанным в мировой литературе.
Список литературы
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2. Al-Salem A.H. Congenital spigelian hernia and cryptorchidism: cause or coincidence? Pediatr Surg Int. 2000; 16(5–6): 433–6. https://doi.org/10.1007/s003839900292
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Russian Journal of Pediatric Surgery. 2023; 27: 304-316
Spigelian hernia in children: a case report and meta-analysis of the literature
https://doi.org/10.55308/1560-9510-2023-27-4-304-316Abstract
Introduction. Spigelian hernia (SH) or hernia of the Linea semilunaris is an extremely rare disease in the pediatric practice. Though it is a congenital malformation, it is revealed and treated surgically mostly at the age of over 50.
Clinical observation. A 6-month-old girl was surgically treated for SH at the Ilyinskaya Hospital. The child had been followed up since her birth for terminal hydronephrosis, complicated by the rupture of renal pelvis. At the age of 4 months, because of absent functions and recurrent infection in the urinary system, the child survived nephroureterectomy. On day 4 after surgery, the patient demonstrated signs of anxiety and pain. Ultrasound examination revealed a strangulated right-sided SH. The hernia was invaginated under ultrasound control. There were no SH relapses during the dynamic follow-up. At the age of 6 months, SH laparoscopic plasty with local tissues was made. There were no complications. There were no any signs of SH relapse for the following 3 months.
Conclusions. The search in the literature sources showed that for over 90-year period only 95 cases of SH in children have been described. The article also describes SH direct and indirect signs, possible complications and options for surgical treatment. Laparoscopic SH correction was performed only in 4 cases in children aged 11 months and older. The case presented by the authors is the 5th SH laparoscopic correction in the world.
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37. Thakur S.K., Gupta S., Goel S. Traumatic spigelian hernia due to handlebar injury in a child: a case report and review of literature. Indian J Surg. 2013; 75(Suppl 1): 404–6. https://doi.org/10.1007/s12262-012-0734-y
38. Vega-Mata N., Vázquez-Estevez J.J., Montalvo-Ávalos C., RaposoRodríguez L. Laparoscopic Spigelian hernia repair in childhood. Literature review. Cir Cir. 2019; 87(1): 101–5. https://doi.org/10.24875/CIRU.18000338
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41. Sengar M., Mohta A., Neogi S., Gupta A., Viswanathan V. Spigelian hernia in children: low versus classical. J Pediatr Surg. 2018; 53(11): 2346–8. https://doi.org/10.1016/j.jpedsurg.2018.06.016
42. Deshmukh S.S., Kothari P.R., Gupta A.R., Dikshit V.B., Patil P., Kekre G.A., Deshpande A., Kulkarni A.A., Hukeri A. Total laparoscopic repair of Spigelian hernia with undescended testis. J Minim Access Surg. 2019; 15(3): 265–7. https://doi.org/10.4103/jmas.JMAS_196_18
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