Differenzialdiagnose des Hüft- und Leistenschmerzes – Aus der Sicht des Viszeralchirurgen

Beschwerden und Schmerzen in der Leistenregion können aus retroperitonealen, intraabdominellen, inguinalen oder muskuloskelettalen Pathologien resultieren. Berücksichtigt werden müssen entzündliche oder tumoröse Veränderungen genauso wie seltene Hernien, die oft nicht offensichtlich sind. Diagnostische und therapeutische Erfolge benötigen häufig interdisziplinäre Ansätze.

Inguinal discomfort and pain may result from retroperitoneal, intraabdominal, inguinal or musculoskeletal pathologies. Hereby inflammatory or malignant alterations are to be considered as well as rare hernias, which may not be evident. Diagnostic and therapeutic success frequently requires an interdisciplinary approach.

Key words

Groin pain - hernia - forwarded inflammation - rectus sheath hematoma - nephrolithiasis

• Literatur

• 1 Muschaweck U, Berger L. Minimal Repair technique of sportsmen's groin: an innovative open-suture repair to treat chronic inguinal pain. Hernia 2010; 14: 27-33
• 2 Mikkelsen T, Bay-Nielsen M, Kehlet H. Risk of femoral hernia after inguinal herniorrhaphy. Br J Surg 2002; 89: 486-488
• 3 Mantoo SK, Mak K, Tan TJ. Obturator hernia: diagnosis and treatment in the modern era. Singapore Med J 2009; 50: 866-870
• 4 Yau KK, Siu WT, Chau CH et al. Laparoscopic management of incarcerated obturator hernia. Ca J Surg 2005; 48: 76-77
• 5 Zhang H, Cong JC, Chen CS. Ileum perforation due to delayed operation in obturator hernia: A case report and review of literatures. WJG 2010; 16: 126-130
• 6 Losanoff JE, Basson MD, Gruber SA, Weaver DW. Sciatic hernia: a comprehensive review of the world literature (1900–2008). Am J Surg 2010; 199: 52-59
• 7 Bernard AC, Lee C, Hoskins J et al. Sciadic hernia: laparoscopic transabdominal extraperitoneal repair with plug and patch. Hernia 2010; 14: 97-100
• 8 Witney-Smith C, Undre S, Salter V, Al-Akraa M. An unusual case of a ureteric hernia into the sciatic foramen causing urinary sepsis: successfully treated laparoscopically. Ann R Coll Surg Engl 2007; 89: 1-3
• 9 Galyfos G, Karantzikos G, Palogos K et al. Spontaneous rectus sheath hematoma in the elderly: an unusual case and update on proper management. Case Rep Emerg Med 2014; 2014: 675-678
• 10 Smithson A, Ruiz J, Perello R et al. Diagnostic and management of spontaneous rectus sheath hematoma. Eur J Intern Med 2013; 24: 579-582
• 11 Michalinos A, Moris D, Vernadakis S. Amyand's hernia: a review. Am J Surg 2014; 207: 989-995
• 12 Pandey D, Coondoo A, Shetty J, Mathew S. Jack in the box: inguinal endometriosis. BMJ Case Rep published online 31 March 2015;
• 13 Mei-Dan O, Lopez V, Carmont MR et al. Adductor tenotomy as a treatment for groin pain in professional soccer players. Orthopedics 2013; 36: 1189-1197