黄体血腫の鼠径ヘルニア嵌頓に対して腹腔鏡下付属器摘出術と鼠径ヘルニア根治術を同時に施行した1例

A case of laparoscopic salpingo-oophorectomy and inguinal hernia repair for incarcerated inguinal hernia containing hematoma of corpus luteum

◆要旨：患者は46歳，女性．左鼠径部膨隆・疼痛を主訴に当科外来を受診した．CTにて，卵巣腫瘍の脱出による左鼠径ヘルニアの診断となり，産婦人科に紹介となった．精査のうえ，後日手術予定となっていたが，受診6日目に嵌頓による疼痛のため，産婦人科と合同で緊急手術となった．腹腔鏡下左付属器摘出＋鼠径ヘルニア根治術（TAPP法）を施行した．術後5日目に合併症なく退院した．病理組織学的検査では，黄体血腫を認めた．術後18か月経過後も，左鼠径部膨隆や痛みを認めていない．本症例は黄体血腫による鼠径ヘルニア嵌頓に対し腹腔鏡下で付属器摘出術と鼠径ヘルニア根治術を同時に施行した稀な症例であるため，若干の文献的考察を加えて報告する．

　A 46-year-old woman visited our hospital for left inguinal bulging and pain. Abdominal CT scan revealed left inguinal hernia with a incarcerated ovarian tumor, and we referred her to obstetrics. After pre-operative examinations, an operation was planned. However, 6 days after her initial visit, her left inguinal pain increased by the incarceration of hernia. We performed emergency laparoscopic left salpingo-oophorectomy and inguinal hernia repair（transabdominal preperitoneal approach ; TAPP） with obstetricians. The postoperative course was uneventful and the patient was discharged on postoperative day 5. Pathology confirmed hematoma of corpus luteum. The patient has remained free from inguinal bulging and pain in the 18 months since surgery. We report a rare case of incarcerated inguinal hernia containing hematoma of corpus luteum that was treated simultaneously by laparoscopic salpingo-oophorectomy and inguinal hernia repair.