Abstract
Obturator hernias (OHs) are rare pelvic hernias that involve the protrusion of intraperitoneal or extraperitoneal organs or tissues through the obturator foramen. Risk factors for OH patients include female gender, chronic disease, age, malnourishment, history of multiple pregnancies, anatomical enlargement of obturator foramen, increased intraabdominal pressure, and defective collagen metabolism. Since OHs have the highest mortality rate of all abdominal hernias, prompt diagnosis and treatment are critical. Prior research has demonstrated an increased likelihood of bilateral OHs relative to unilateral. We present the case of a 79-year-old female who presented with an obstructed OH six months after an operation for an OH on the contralateral side. Due to the potential morbidity and mortality associated with OHs and delay in discovery, we suggest evaluation and treatment of the contralateral side in patients who present with unilateral OHs.
Highlights
Obturator hernias (OHs) are rare pelvic hernias that involve the protrusion of intraperitoneal or extraperitoneal organs or tissues through the obturator foramen
Prior research has demonstrated an elevated percentage of OHs involving bilateral as opposed to unilateral presentation
It has been suggested that the incidence of bilateral OHs would be increased further if surveillance of the pelvis intraoperatively was done routinely in hernia repairs
Summary
Obturator hernias (OHs) are rare pelvic hernias that involve the protrusion of intraperitoneal or extraperitoneal organs or tissues through the obturator foramen [1]. The patient was a 79-year-old female who presented to the emergency department with an eight-hour history of abdominal pain associated with nausea and vomiting She complained of obstipation for the past day as well as right hip pain. The nasogastric tube was removed on POD 2 and the patient was started on clear liquids diet She regained full bowel function on post-operative day 3. The patient began belching but did not develop nausea or vomiting She underwent a CT scan of the abdomen and pelvis in the ED that demonstrated a left-sided obturator hernia as well as small bowel obstruction (Figures 3, 4). Recovery proceeded in a timely fashion as in her previous hospitalization Her NG tube was removed on post-operative day 2 and she was started on a clear liquid diet.
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