Computed tomographic diagnosis of obturator hernia and its surgical management: A case series

Hernia through the obturator canal is usually unsuspected and hence undiagnosed. Patients with obturator hernias present as acute cases of intestinal obstruction secondary to strangulation or incarceration, with high rate of morbidity and mortality due to delayed diagnosis and treatment. The know incidence of obturator hernia is low, representing 0.073% (11 of 15,098) of all hernias repaired at the Mayo Clinic in a retrospective study of 15 years. In this study, we conducted a retrospective analysis of laparoscopic extraperitoneal hernia repairs that were performed between the years 2003 and 2007. All procedures were undertaken by 2 experienced surgeons who performed more than 150 previous surgeries. In 293 patients who underwent repair of bilateral or recurrent inguinal hernia, exploration of the obturator foramen was conducted looking for obturator hernia, which was found in 20 cases (6.82% of patients). The true incidence of obturator hernia is greater than that reported in the literature, and the chances of detecting hernia are greater if an equal number of men and women are scanned could be higher if pelvic scanning was performed.

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“…A large proportion (approximately two-thirds) of obturator hernias are not diagnosed until exploratory laparotomy. [ 11 ]…”

Section: Discussionmentioning

confidence: 99%

Obturator hernia as a frequent finding during laparoscopic pelvic exploration

Susmallian

Ponomarenko²,

Barnea³

et al. 2016

Medicine

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“… 1 Although rare, incarcerated OH can have a mortality rate as high as 70%, and it is for this reason that an accurate and fast diagnosis is made to guide surgical management. 2 In 90% of cases, the most common clinical presentation is intestinal obstruction. 2 Although not present in this case, OH is associated with other classical signs such as the Howship–Romberg sign and the Hannington-Kiff sign.…”

Section: Discussionmentioning

confidence: 99%

“… 2 In 90% of cases, the most common clinical presentation is intestinal obstruction. 2 Although not present in this case, OH is associated with other classical signs such as the Howship–Romberg sign and the Hannington-Kiff sign. 3 OH is more common in females than males (ratio 6 : 1) and classically presents in elderly, emaciated multiparous females.…”

Section: Discussionmentioning

confidence: 99%

“… 3 OH is more common in females than males (ratio 6 : 1) and classically presents in elderly, emaciated multiparous females. 2 It is for this reason that it has been named the “skinny old lady hernia. Risk factors are associated with conditions that increase intra-abdominal pressure and include chronic constipation, multiparity, chronic obstructive pulmonary disease, ascites and kyphoscoliosis.…”

Section: Discussionmentioning

confidence: 99%

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A rare presentation of small bowel obstruction

Darwish

Bell

2017

BJR|case reports

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A 92-year-old, 41 kg female presented with a 4-day history of abdominal distension, intermittent lower abdominal pain, nausea, vomiting and lack of bowel opening. Contrast-enhanced CT scan of the abdomen and pelvis showed multiple dilated small bowel loops, secondary to incarceration of the ileum in an obturator hernia (OH) on the right. The patient underwent an emergency laparotomy with reduction of the OH. The small bowel was viable and no resection was required. OH is a rare but significant cause of small bowel obstruction, with a high mortality rate. Of all the imaging modalities reviewed, CT scan is highly effective in reducing diagnostic delay, and ultimately can reduce morbidity and mortality rates of patients presenting with an incarcerated OH.

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“…[2] Diagnosis is often delayed until laparotomy for bowel obstruction. [3] Strangulation is frequent and mortality remains high (25%–47.6%[45]). Primary closure of the hernia defect is difficult because adjacent tissues are not easily mobilized.…”

Section: Introductionmentioning

confidence: 99%

Obturator hernia

Shreshtha

2016

Journal of Postgraduate Medicine

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A 70 year old lady presented to surgery emergency with small bowel obstruction without any obvious etiology. On exploration she was found to have an obstructed obturator hernia, which is a rare pelvic hernia with an incidence of 0.07-1.4% of all intra-abdominal hernias. Diagnosis is often delayed until laparotomy for bowel obstruction. Strangulation is frequent and mortality remains high (25%). Early diagnosis and surgical treatment contributes greatly to reduce the mortality and morbidity rates. A variety of techniques have been described, however surgical repair has not been standardized. It is an important diagnosis to be considered in elderly patients with intestinal obstruction.

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Computed tomographic diagnosis of obturator hernia and its surgical management: A case series

Cited by 17 publications

References 14 publications

Obturator hernia as a frequent finding during laparoscopic pelvic exploration

Obturator hernia as a frequent finding during laparoscopic pelvic exploration

A rare presentation of small bowel obstruction

Obturator hernia

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