Strangulated Obturator Hernia: Difficult Diagnosis

Abstract

Abstract:The obturator hernia is rare and its diagnosis is frequently missed. It is a rare cause of intestinal obstruction. Patients present with few clinical signs to identify the cause, apart from symptoms of intestinal obstruction. Therefore, obturator hernias are often diagnosed at laparotomy with a high motality rate. CASE REPORT: We recently encountered this lesion in a 75 year old woman presented with a history of right iliac fossa pain, bilious vomiting, abdominal distension. Non-specific findings on examination and blood tests made the diagnosis difficult, however, a CT scan of her abdomen revealed the site of the obstruction and the patient was taken to theatre for emergency surgery. She underwent a midline laparotomy and resection and anastomosis of small bowel and repair of the strangulated right obturator hernia. She presented a tachyrdia six days after surgery. The patient died of peritonitis postoperative (anastomotic dehiscence). The high mortality rate associated with this type of abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and prompt surgical intervention if the survival rate is to be improved.