Sciatic hernia clinically mimicking obturator hernia, missed by ultrasonography: case report

Abstract

Siyatik herni, büyük veya küçük siyatik foramen içinden geçerek oluşan nadir bir pelvis tabanı hernisidir. Siyatik herniler, özellikle kadınlarda sıklıkla pelvik ağrı şeklinde belirti verir ve tanısı güç olabilir. Siyatik herni, ince bağır-sak tıkanıklığının belirti ve semptomları olan ilgili taraftaki gluteal bölgede şişlik veya pelvik ağrı şeklinde belirti verebilen en nadir internal herni formlarından birisidir. Laparoskopik onarımı da içeren transabdominal ve transgluteal operatif yaklaşımlar rapor edilmiştir. Biz, içeriği şeklin-de de hapsolmuş ince bağırsakla birlikte olan bir sol taraflı siyatik herni olgusunu sunuyoruz. Herni, ultrasonografi ve düz abdominal grafi tarafından atlanmış ve obturator herniyi düşündürmüştür.Anahtar Sözcükler: Siyatik herni; obturator herni; bağırsak tıka-nıklığı.Sciatic hernia is a rare pelvic floor hernia that occurs through the greater or lesser sciatic foramen. Sciatic hernias often present as pelvic pain, particularly in women, and diagnosis can be difficult. Sciatic hernia is one of the rarest forms of internal hernia, which can present as signs and symptoms of small bowel obstruction, swelling in the respective gluteal region or pelvic pain. Transabdominal and transgluteal operative approaches, including laparoscopic repair, have been reported. We present a case of left-sided sciatic hernia with incarcerated small bowel as its contents. The hernia was missed by ultrasonography and plain abdominal radiography, but the clinical features were suggestive of an obturator hernia.

Successful manual reduction for ureterosciatic hernia: A case report

“…A search of English-language abstracts in PubMed and Igakuchuo-Zasshi through 2017, with keywords of “sciatic hernia” or “ureterosciatic hernia” revealed a total of 71 patients with sciatic hernias [1,[3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45], [46], [47], [48], [49], [50], [51], [52], [53], [54], [55], [56], [57], [58], [59], [60], [61], [62], [63], [64], [65], [66], [67], [68], [69], [70]]. Of 72 patients with a sciatic hernia including the present patient, for whom comprehensive data were found, there were 61 adults (age 29–93 years) (Table 1) and 11 children (age 2–660 days) (Table 2).…”

Choice of imaging modality in the diagnosis of sciatic hernia

“…The wide variability in contents leads in turn to a range of presentations. Cases have been reported with both acute and chronic symptom duration [2–5]. Half of patients report non-specific abdominal or pelvic pain and one third have a mass on clinical examination [1].…”

“…Half of patients report non-specific abdominal or pelvic pain and one third have a mass on clinical examination [1]. Sciatica, intestinal obstruction, urinary sepsis and hydronephrosis have also been described [1–5]. Diagnostic laparoscopy or laparotomy is often required to fully evaluate the sac contents and to repair the defect [2, 3, 5].…”

“…Sciatica, intestinal obstruction, urinary sepsis and hydronephrosis have also been described [1–5]. Diagnostic laparoscopy or laparotomy is often required to fully evaluate the sac contents and to repair the defect [2, 3, 5]. In symptomatic patients, surgical repair is indicated due to the high risk of bowel strangulation [1, 3].…”

“…Commonly used imaging modalities are computerized tomography (CT) [2–5] and MRI [3, 4], particularly if the sciatic nerve is thought to be involved. Currently, the most commonly used imaging modality of choice is a CT scan with the patient supine.…”