連續性可攜帶式腹膜透析患者腹股溝疝氣導致陰囊水腫

Scrotal Edema Induced by Inguinal Hernia in a Continuous Ambulatory Peritoneal Dialysis Patient

陰囊水腫是接受連續性可攜帶式腹膜透析治療患者的一種少見但有明確證據的併發症。最常見的原因是來自間接疝氣囊或未關閉的鞘狀突的液體外滲。目前已有發展數種影像檢查可進行診斷，包括超音波、Tc-99m DTPA核醫腹膜閃爍掃描、電腦斷層（CT）腹膜造影和核磁共振（MR）腹膜造影。我們在此報告一例發生陰囊水腫的連續性可攜帶式腹膜透析患者，並利用電腦斷層腹膜造影，診斷出伴有未關閉的鞘狀突的間接腹股溝疝氣。患者接受了成功的疝氣修補手術，並於術後2週重新開始連續性可攜帶式腹膜透析治療。電腦斷層腹腔造影是合適的診斷工具，除可提供解剖細節，也有助於設計手術計劃。建議早期發現並及時手術修補連續性可攜帶式腹膜透析患者的腹股溝疝氣，以防止更嚴重的併發症。

Scrotal edema is a rare but well-documented complication in patients with continuous ambulatory peritoneal dialysis (CAPD). It is often caused by fluid extravasation from an indirect hernial sac or patent processus vaginalis. Various diagnostic imaging examinations, including ultrasonography, peritoneal scintigraphy with Tc-99m DTPA, computed tomographic (CT) peritoneography and magnetic resonance (MR) peritoneography, have been developed for scrotal edema. In this case report, we describe a CAPD patient who developed scrotal edema due to an indirect inguinal hernia with patent processus vaginalis, which was diagnosed by CT peritoneography. The patient underwent successful surgical repair, and CAPD treatment was resumed two weeks after operation. CT peritoneography is a suitable diagnostic tool for providing anatomical details and adding in surgical plan. Early detection and prompt surgical repair of inguinal hernia in CAPD patients are advised to prevent more serious complications.