Obturator hernia

Abstract

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.

Obturator Hernia: A Rare Cause of Small Bowel Obstruction

“…As the poor general condition of the patient demanded speedy completion of the operation, we made a lower midline abdominal incision. The intraoperative exploration revealed pelvic effusion and right obturator hernia with ileal strangulation (Richter’s hernia) ( 3 ). We dilated the constriction using a vascular clamp and reduced the hernia.…”

Obturator hernia: a case report

“…This is due to compression of the cutaneous branch of the obturator nerve. This sign, however, is estimated to be present in less than 50% of cases [ 9 ]. The Hannington-Kiff sign occurs when there an intact patellar reflex with a concurrent loss of the thigh adductor reflex.…”

“…This is due to obturator nerve compression causing weakness of the adductor muscles. This sign is considered to be more specific; however, it is less commonly seen [ 9 , 10 ]. These maneuvers were not performed on our patient since a CT scan had revealed obturator hernia.…”

Small bowel obstruction as a result of an obturator hernia: a rare cause and a challenging diagnosis

“…A laparotomy additionally allows inspection of the bowel for viability. Early diagnosis and surgical intervention are fundamentals to lead to better outcomes for the patients [ 7 , 8 ].…”