2018 Volume 38 Issue 6 Pages 983-988
With the aim of clarifying the preoperative factors for intestinal resection in an incarcerated groin hernia (IGH), we investigated cases of IGH in our department. 【Patients】 37 patients who underwent an emergency operation for IGH were divided into the following 2 groups by bowel resection: the resection group (n=10) and the non-resection group (n=27). 【Results】 Four items were found to be significantly different between the two groups; age, time from onset to hospital visit, serum CRP level, and the CT value of the incarcerated intestine contents. Logistic regression analysis revealed that the CT value was the only significant independent factor. The cut off value calculated using a receiver operating characteristic curve of CT values was 20 HU, with a sensitivity of 70％ and a specificity of 96％. We experienced a case which caused a late-onset stricture of small intestine after a reduction of IGH. In this case, a preoperative CT image revealed a precipitation image in the back region of the incarcerated intestine. In such a case, the CT value needs to be measured in the precipitated region. 【Conclusion】 the CT value is useful to judge the reversibility of intestinal ischemia, the indication of manual reduction and the necessity for bowel resection.
