Strange Obturator Hernia: A Case Report with Literature Review

Abstract

Obturator hernia is a rare pelvic hernia with incidence of 1%. It’s a significant cause of intestinal obstruction in emaciated elderly women. Delayed diagnosis and surgical intervention contributed to its relatively high morbidity and mortality. We present a case of an elderly woman with occlusive syndrome. The diagnosis of a strange obturator hernia was confirmed by a spiral CT scan. The bowel was located between the external obturator and pectineal muscles, corresponding to a mechanical obstruction upstream of a right obturator hernia. During the emergency laparotomy, the surgeon performed a gentle reduction of the incarcerated small bowel which was viable and closure of the obturator foramen by plication of the parietal peritoneum. The patient recovered uneventfully and no recurrence occurred during the follow-up. The obturator hernia should be included in the differential diagnosis if clinically suspected. Early diagnosis and prompt surgical treatment are essential to reduce the morbidity and mortality associated with obturator hernia.