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{'症例は72歳,女性.40歳頃より腹壁瘢痕ヘルニアを指摘されていた.心窩部痛と嘔吐を主訴に来院した.左側腹部に直径25cmの腹壁瘢痕ヘルニアを認め,腹部CTでは腹壁瘢痕ヘルニア内にS状結腸と小腸が脱出していた.小腸の造影効果は軽度低下していたが,腸閉塞所見はなかったため,入院後保存的に加療を行った.入院3日目にも病状は改善せず,再度CT検査を行ったところ,脱出小腸の造影効果は消失し,腸閉塞所見も出現していたため緊急手術を行った.ヘルニア嚢内に下行結腸からS状結腸が脱出し,さらにS状結腸腹膜垂がヘルニア嚢に癒着することで小腸35cmが内ヘルニアとなり壊死性変化を伴い拡張していた.腹膜垂を切開して壊死腸管を切除,腹壁瘢痕ヘルニアの修復も行った.腹壁瘢痕ヘルニア内で発症した絞扼性イレウスおよび腹膜垂による腸閉塞はいずれもまれであり,文献的考察を含めて報告する.': [0]}, 'cited_by_api_url': 'https://api.openalex.org/works?filter=cites:W2316433007', 'counts_by_year': [{'year': 2023, 'cited_by_count': 1}, {'year': 2021, 'cited_by_count': 1}], 'updated_date': '2024-09-13T23:57:45.422440', 'created_date': '2016-06-24'}