Abstract
IntroductionAlthough relatively rare, an obturator hernia is a significant cause of intestinal obstruction. It usually occurs in emaciated elderly females. Computed tomography is the imaging modality of choice to diagnose obturator hernias.Case reportIn this report we present a case of an elderly female who presented to the emergency department with features suggesting bowel obstruction. The patient was admitted to the hospital and was initially managed conservatively. Two days later the patient underwent an exploratory laparotomy and was diagnosed with a left sided Richter type obturator hernia. The hernia was successfully reduced and the necrotic bowel was resected with end to end anastomosis.DiscussionAn obturator hernia is a rare type of abdominal hernias which often occurs in very thin old females. Patients with obturator hernias usually present with symptoms of acute or intermittent small bowel obstruction. Mild symptoms without abdominal pain may be due to incomplete obstruction or Richter type hernia. Computed tomography is considered the gold standard diagnostic modality for obturator hernias. An early surgical intervention is the treatment of choice.ConclusionThe clinical diagnosis of an obturator hernia is often difficult due to its nonspecific symptoms and infrequent signs. Yet early diagnosis is mandatory because its delay contributes to bowel necrosis and to the poor prognosis in these patients. Surgery remains the only effective management of this condition.
Highlights
Relatively rare, an obturator hernia is a significant cause of intestinal obstruction
We report a patient who presented to our emergency service with manifestations of bowel obstruction resulting from an incarcerated abdominal hernia
An obturator hernia is a rare type of abdominal hernias, accounting for 0.5–1.4% of all hernias [1]
Summary
Obturator hernia is a rare clinical condition that may cause intestinal obstruction. It accounts for 0.5–1.4% [1] of all abdominal hernias and usually occurs in elderly emaciated multiparous women [2]. The diagnosis of this disease is often delayed because it is difficult to detect [1]. Patients with delayed diagnosis often have high morbidity and mortality rates and most of them undergo partial intestinal resection [3]. We report a patient who presented to our emergency service with manifestations of bowel obstruction resulting from an incarcerated abdominal hernia
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