A CASE OF NON-STRANGULATED BILATERAL OBTURATOR HERNIA DIAGNOSED BY HERNIOGRAPHY

Abstract

We report a case of non-strangulated bilateral obturator hernias which was diagnosed preoperatively by herniography. A 75-year-old woman had been treated for bilateral thigh pain since three years before. Although no pain was complained of when she was referred to the surgical clinic, a Howship-Romberg sign was assumed on the basis of her medical history. Herniography demonstrated bilateral obturator hernias. She underwent surgery through a retropubic extraperitoneal approach under spinal anesthesia. Empty hernial sacs were identified in the bilateral obturator canals. Repair of both hernia porta was performed by approximating the pubic periosteum and obturator membrane. Herniography is mandatory in the preoperative diagnosis of non-incarcerated obturator hernia. Recently, reports on bilateral obturator hernias are increasing in number. We consider the retropubic extraperitoneal operative approach to be the most appropriate procedure, because bilateral obturator foramens can be identified through one common incision.