当院における大腿ヘルニア手術26症例の臨床的検討

We performed this study to investigate the differences in clinical features between incarcerated femoral hernias and non-incarcerated cases. We operated on 26 patients with a femoral hernia from April 1989 to December 1998. Twenty-four patients were female and two were male. Thir mean age at the time of operation was 68.2±15.4 years, and those older than 60 years were remarkably high. All females had a history of abortion more than twice. Eighteen of 26 (69.2%) hemoral hernias occurred on the right side, 7 on the left, and 1 on both sides. Those with an incarcerated hernia were 46.2% (12/26). Almost all patients without incarceration had only femoral tumors or swelling. On the contrary, a large number of the patients with an incarcerated hernia complained of abdominal or femoral pain, suggesting a hernial strangulation. Significant increases in white blood cell counts were recognized in the incarcerated cases compared to those without incarceration (9158.3± 2155.3 vs 6602.9±1049.5/mm3, respectively;P=0.0001). Additionally, the postoperative hospitalization periods of the patients with incarcerations were remarkably prolonged compared to those without an incarceration. According to the contents of the hernia in the 12 patients with incarcerations, we detected the small bowel in 9 and the grater omentum in 3. Six of 9 patients with an incarcerated small bowel had necrotic complications of strangulated small bowel. However, there was no clinical difference compared to the other 6 patients without a necrotic small bowel. In conculusion, we should recognize the possibility of femoral hernias in the treatment of patients complaining of a tumor or pain in the femoral triangle.