Prognostic Factors in Obturator Hernia

Abstract

Objective: Obturator hernia is a rare type of hernia that can occur in the octogenarian patients. We discuss the diagnosis, treatment and management of patients with obturator hernia, and describe the clinical presentation, laboratory and radiological findings. Material and methods: A retrospective study was performed in ten patients diagnosed with an obturator hernia between December 2008 - 2019 at a single tertiary hospital. Patients’ demographic features, clinical symptoms, laboratory and imaging data, comorbidities, surgical treatment methods, postoperative morbidity and mortalities were evaluated. Results: The patients’ mean age was 84.4 years (range between 81 - 89 years). All patients presented with symptoms of small bowel obstructions; abdominal pain located in the lower quadrant (100%), vomiting (60%), nausea (80%) and distension (60%). All patients had air-fluid levels on X-ray. We performed small intestine resection and an end to end anastomosis in four patients, resection with ileostomy in two patients and bowel reduction in four patients. Postoperatively, an anastomosis leak occurred in two patients, they were re-operated and an ileostomy was performed. In the post-op period, six patients died, and four patients survived. Conclusion: Obturator hernia is seen in octogenarian patients with symptoms of small bowel obstruction. The diagnosis is based mostly on computed tomography findings. An elevated neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and lactate levels can be used as a biomarker for the prediction of non-viable small bowel in these OH patients.