Type Of Hernia Research Articles

A successful thoracoscopic treatment of bilateral congenital false diaphragmal hernia in a newborn

Introduction. Congenital diaphragmatic hernia (CDH) occurs with frequency of 1:2000 to 1:4000 live births. False CDH are more common. Out of unilateral diaphragm defects, left-sided ones predominate (9–24 times more often depending on hernia type). Bilateral diaphragmatic hernia is an extremely rare malformation which accounts for no more than 1% of all diaphragmatic hernias.
 Description of observation. The authors present their own experience in treating a rare clinical case of bilateral false diaphragmatic hernia in a newborn with the left-sided component manifested immediately after the birth and with the right-sided one – in 2 weeks after the correction of the first one, as well as its successful thoracoscopic treatment.
 Conclusion. The authors consider that one of the possible reasons for not detecting this pathology at ultrasound examination is translocation of the abdominal organs to the chest (which can occur antenatally, intra- and postnatally).

Simultaneous stoma closure and type IV parastomal hernia repair after botulinum toxin and progressive pneumoperitoneum

Abstract Surgery is the only treatment for parastomal hernia (PH). When possible, stoma closure is the best way to manage this type of hernia, however, whether to perform it in a single approach with abdominal wall reconstruction (AWR) is still debatable. A 58-year-old woman with a type IV PH with loss of domain was submitted to preoperative optimization [botulinum toxin type A and progressive pneumoperitoneum (PPP)], followed by simultaneous stoma closure and AWR. Hospital discharge was on the eighth day with no complications. Six months later, no clinical evidence of recurrence or other complication was observed. Large PHs are technically challenging. Stoma closure and simultaneous AWR increase surgical risk. Preoperative optimization with a combination of adjuvants (including PPP) is feasible in PH and may overcome technical complexity, even though patient selection remains the key when choosing a PH repair with synchronous stoma closure.

Outcome of emergency groin hernia repair in a district general hospital.

Abstract Background Tension free mesh repair is considered as gold standard technique for elective groin hernia repair. However, use of synthetic mesh remains controversial in the presence of gangrenous bowel, contaminated or infected surgical field. Aims/ Objective This study aimed to evaluate the outcome of emergency groin hernia repair, to assess the safety of mesh repair and explore risk factors of postoperative complications for adult patients with incarcerated groin hernia. Methods From April 2019 to August 2022, consecutive adult patients who underwent emergency repair for incarcerated groin hernia in our trust were retrospectively reviewed. Data was collected from electronic patient record, which includes patient demographics, type of hernia, repair (mesh/ non mesh), and the outcome in terms of early and late postoperative complications. Results 153 patients underwent emergency groin hernia repair, of these 137 were primary and 15 recurrent. Median age was 75.5 (range 23 to 96), with male to female ratio 3:1. 80 percent cases were inguinal hernia and 20 percent femoral. 75 percent patients had mesh repair and remaining had suture repair done. Bowel resection was performed in 11 cases. Early complications were reported in 7 cases (hematoma 2, seroma 2, chronic pain 2 , recurrence 1 and infection 1) and late complications within 90 days were seen in 5 cases (recurrence, groin pain, adhesions). Conclusions Polypropylene mesh could be safely used in incarcerated groin hernia repair. However, suture repair is recommended when bowel resection is required. Delay in surgical repair, obesity and co-morbidities are risk factor of post-operative complications.

The initial outcomes of laparoscopic surgery for the hiatal hernia repair: a tertiary center study

Background: The surgical approach to hiatal hernia has changed with the advent of laparoscopic techniques. We sought to evaluate the short-term outcomes of laparoscopic hiatal hernia repair. Methods: We conducted a cross-sectional study with a retrospective approach of patients receiving laparoscopic hiatal hernia repair from January 2018 to June 2023 at People’s Hospital 115. Results: In 25 patients included in this study, the male-to-female ratio was 2:1, with a mean age of 46. The types of hiatal hernia included type I (n = 2), III (n = 16), and IV (n = 7). The most common symptoms were epigastric pain (44%), dysphagia (16%), heartburn (25%), vomiting (76%), chest pain (32%), and shortness of breath (20%). Nissen fundoplication was also performed in 19 cases (76%). The median operative time was 130 min, and the median hospital stay was 3 days. No case was converted to open surgery, and minor or major complications occurred in 3 patients (12%). Conclusion: Laparoscopic repair for hiatal hernia is feasible and safe. The short-term outcomes included early return daily activities, and most patients experienced good to excellent functional and symptomatic results and quality-of-life improvement.

Hernia among Patients Admitted to the Department of Surgery of a Tertiary Care Centre.

Hernia is one of the most common surgical conditions causing disability and requiring hospital admission and surgery. The aim of this study was to find out the prevalence of hernia among patients admitted to the Department of Surgery of a tertiary care centre. A descriptive cross-sectional study was conducted among patients admitted to the Department of Surgery between 14 April 2021 and 13 April 2023 and were collected from 1 July 2023 to 31 July 2023 from the hospital records. Ethical approval was obtained from the Institutional Review Committee. The patient admitted to the Department of Surgery was included and those with incomplete data were excluded. Convenience sampling was used. The point estimate was calculated at a 95% Confidence Interval. Out of 2057 patients, the prevalence of hernia was 247 (12.01%) (10.61-13.41, 95% Confidence Interval). A total of 31 (12.55%) hernias were irreducible and 15 (6.07%) were operated in the emergency setting. The most common type of hernia was inguinal hernia found in 169 (68.42%) and hypertension was the most common comorbidities found in 48 (19.43%). The prevalence of hernia was similar to other studies done in similar settings. Hernia accounts for a major surgical burden in our setting. So, early diagnosis and treatment could reduce the morbidity and mortality related to it. hernia; inguinal hernia; prevalence; surgery; umbilical hernia.

Hernia repair techniques: a comparative analysis of mesh types

A hernia is a condition characterized by the protrusion of an internal organ, often part of the intestine, through a weakened area in the surrounding muscle and tissue. Surgical intervention is the primary treatment option for most hernias, with procedures known as herniorrhaphy or hernioplasty. Traditional open surgery involves a sizable abdominal incision, granting direct access to the herniated tissue. Alternatively, minimally invasive laparoscopic surgery utilizes small incisions and specialized instruments, including a camera, for repair. Synthetic or biological mesh is frequently employed to reinforce weakened muscle or tissue, reducing hernia recurrence risk. Mesh is integral to hernia treatment, providing critical reinforcement and enabling tension-free closure. This article's rationale lies in the necessity for a comprehensive comparative analysis of hernia repair techniques, with a particular focus on the influence of different mesh types in abdominal hernia surgery. This research, initiated on 17 October 2023, involved an exhaustive review of existing literature via databases like PubMed, Web of Science, and Cochrane, employing a broad range of medical terminology combinations. The management of hernias has evolved significantly, and open hernia repair, especially using the Shouldice technique, remains valuable when the mesh is unavailable or undesired. Modern tension-free repair techniques, such as Lichtenstein and plug and patch, provide similar outcomes. Laparoscopic hernia repair, despite the longer surgery duration, offers advantages in terms of recurrence, recovery, and postoperative discomfort. Mesh selection is vital, with options like polypropylene, polyester, composite, biological, and 3D offering tailored attributes. The choice should consider patient history, hernia type, and surgeon expertise, necessitating awareness of evolving techniques and materials for optimal outcomes in hernia repair.

Controversies Regarding Mesh Utilisation and the Attitude towards the Appendix in Amyand’s Hernia—A Systematic Review

Inguinal hernia containing the vermiform appendix is a rare entity. It is more common in children than in adults. It can be discovered incidentally during the surgical intervention performed for the cure of the inguinal hernia or when the appendix shows inflammatory changes, a situation that can lead to diagnostic confusion with a number of other diseases. Imaging can guide the diagnosis, which often comes as an intraoperative surprise. The therapeutic approach is controversial both in terms of whether or not to perform an appendectomy in the case of an appendix without inflammatory changes and especially in terms of using a mesh during the hernia repair process. Since the pathology is not very frequent, there are no standardized stages in terms of surgical ethics that can guarantee good surgical practice. The study aimed to carry out a review of the specialized literature to obtain some conclusions or trends regarding the management of this pathology. The low frequency of this type of hernia did not allow the consultation of large-scale studies or extensive reviews focusing on case reports or case series communications. The obtained results were statistically analyzed and integrated in relation to the surgical attitude depending on the particularities of the condition.

Frequency of Abdominal Wall Hernias: A Nigerian Hospital Experience

Introduction: Hernia is a very common condition in all populations, and its surgical operation constitutes a major workload for physicians worldwide. Although great numbers of these procedures are done in primary and secondary care settings as well as in private hospitals and as part of surgical missions to rural areas, a significant proportion is still present in tertiary centers. Aim: To review the pattern of external hernias operated upon in Federal Medical Centre, Owerri, over a 10-year period. Methods: The theatre records were searched for all patients who underwent surgical operations for hernia in the period of 2005–2014. The data on patient demographics, indication for surgery, and procedure performed were retrieved. Results: A total of 902 patients underwent operations for different types of external hernias. The overall male/female ratio was 2.6:1. Operations for inguinal hernia were the most common, accounting for 72.9% (658) of the total. Ventral hernias constituted 25.1% (n=227) of the cases whereas 1.5% (n = 12) of patients had femoral hernia. One hundred and twelve patients (12.4%) had emergency surgery, of which 78 were for inguinal hernia. Mesh repair was started in 2009 and was utilized in 72 (8%) cases. Laparoscopic method of repair was used in only two patients. Conclusion: The pattern of operation for hernia in our center mirrors the experience in other local centers. Modern methods of repair are gaining ground.

OGBN O07 Factors in recurrence following 862 giant paraesophageal hernia repairs

Abstract Background Repair of giant paraesophageal hernia (PEH) is associated with a considerable hernia recurrence rate by objective measures. This study evaluated trends in outcomes of laparoscopic non-mesh repair of giant PEH over 30 years, and factors associated with anatomical recurrence. Methods Data was extracted from a single-surgeon prospective database of laparoscopic repair of giant PEH from 1991-2021. Upper endoscopy was performed within 12 months postoperatively and selectively thereafter. Any supra-diaphragmatic stomach was defined as anatomical recurrence. Cases were chronologically divided into tertiles with trends in casemix, operative factors and outcomes evaluated. Patient and hernia characteristics, and technical operative factors, including “composite repair” (360-degree fundoplication with esophagopexy and cardiopexy to right crus), were evaluated with univariate and multivariate analysis. Results 862 repairs met selection criteria. Mean age 69.3years, majority(65.8%) female and hernia type III(87.4%) with median hernia size 66%. There was an increasing proportion of “composite repair” after the first decade(Group1, 2.7%;Group2, 81.9%;Group3, 100%;p<0.001).There were less anatomical hernia recurrence(Group1, 36.6%;Group2, 22.9%;Group3, 22.7%;p<0.001) over time. The overall anatomical recurrence rate was 27.3% with median followup 33months(IQR 16, 68). There were 10(1.2%) Clavien-Dindo grade ≥III complications including two perioperative deaths(0.2%). Multivariate analysis identified age<70years, presence of Barrett’s, absence of “composite repair”, and hiatus closure under tension as independent factors associated with recurrence(HR1.27,95%CI0.88-1.82,p=0.01;HR1.58,95%CI1.12-2.23,p=0.009;HR1.72,95%CI1.2-2.44,p=0.002;HR2.05,95%CI1.33-3.17,p=0.001,respectively). Conclusions Hernia recurrence rates decreased with increasing case volume. This coincided with the increasing adoption of “composite repair”, supporting the possible improvement in recurrence rates with this approach. Repair was associated with substantial anatomical recurrence associated with patient and technique factors. Patient factors included age <70 years, Barrett’s esophagus, and hiatus tension. “Composite repair” was associated with lower recurrence rate.

The clinical implications of occult inguinal hernia identified during laparoscopic peritoneal dialysis catheter insertion.

Occult inguinal hernias predispose patients undergoing peritoneal dialysis (PD) to symptomatic inguinal hernia formation causing complications. We conducted a retrospective study to assess the usefulness of routine laparoscopic examination for occult inguinal hernia during PD catheter insertion and the risk profile of occult inguinal hernia according to hernia classification in patients with PD. This study included 79 patients who underwent initial laparoscopic PD catheter insertion between 2021 and 2022. An occult hernia was defined as an internal hernial sac of all sizes that was not detectable on physical examination. The European Hernia Society groin hernia classification was used to describe the hernia type. We investigated the association between event-free survival and occult inguinal hernias in patients undergoing PD. Occult inguinal hernias were diagnosed in 24 (32%) patients. Among these patients, 5 (21%) patients underwent metachronous repair. In patients with L2 occult hernias, the cumulative incidence rates of right and left symptomatic hernias within one year were 100% and 50%, respectively. Multivariate analysis revealed that L2 occult hernias were associated with metachronous hernia repair. The L2 occult inguinal hernia during PD was associated with metachronous repair, suggesting the importance of routine examination of inguinal hernias during laparoscopic PD catheter insertion.

Diaphragmatic Hernia (Bochdalek Hernia) in an Adult: a Case Report

Bochdalek hernia (BH) is the most common type of congenital diaphragmatic hernia and constitutes 85% of cases. In adults BH is extremely rare. Most of them are asymptomatic. We present a case of BH in an adult patient to point out the importance of clinical examination and computed tomography (CT) scan in reaching the exact diagnosis. A 17-year-old male was presented to the surgery department with a 3-days history of recurrent abdominal pain, vomiting and unable to lie flat. The BH was confirmed on computed tomography (CT) imaging and the patient underwent emergency laparotomy and per-operatively we found part of stomach, greater omentum, splenic flexure of colon along with spleen herniated into the left hemithorax through a defect of approximately 8x6cm in the left postero-lateral aspect of the diaphragm. Reduction of hernia contents and surgical repair of the defect was done with non-absorbable suture. His post-operative period was uneventful. Although rare, this disorder should be recognized and treated appropriately to avoid complications. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(1): 64-67

A Rare Combination of Right-sided Richter’s and Amyand’s Hernia

Amyand hernia is a rare form of hernia which is defined by an inguinal hernia containing the appendix. The appendix may or may not be inflamed and in some cases may be incarcerated. Another type of hernia is Richter hernia which occurs when only a portion of the circumference of the bowel is entrapped within a hernia sac. Although having a hernia is one of the most common encounters seen in the surgical field, having the combination of Amyand’s and Richter’s hernia is rarely encountered. We report the rare finding of both types of hernia as well as the finding of a lymph node within the hernial sac in an asymptomatic patient who was presented to the outpatient clinic for routine check-up.

Forecasting The Impact of the 2023 Current Procedural Terminology Coding Changes On Ventral Hernia Work Relative Value Units. A Cross-Sectional Study

BackgroundIn January 2023, significant changes were implemented to ventral hernia repair Current Procedural Terminology codes, with new codes replacing previous codes. The new codes were assigned a 0-day global period. The impact of these changes on clinical productivity remains unclear. Our objective was to forecast the impact of Current Procedural Terminology changes on ventral hernia-related work relative value units using historical data. MethodsVentral hernia repairs performed between March 2021 and December 2022 on adults by a single surgeon with available 90-day follow-up were retrospectively retrieved from the Abdominal Core Health Quality Collaborative. Demographic, hernia, and operative and postoperative data were collected. The ventral hernia repairs were coded twice using the previous and new Current Procedural Terminology codes, and work relative value units were calculated using both systems. The median work relative value units per case were compared using the Wilcoxon signed-rank test. ResultsA total of 143 ventral hernia repairs were included. The median age was 59 years, and 50% of patients were male. Median hernia width and length were 3.5 and 5.0 cm, respectively. The most common ventral hernia types were incisional 57% and umbilical 33%. Twenty percent of hernias were recurrent, and 99% were elective repairs. 49% of the procedures were open, 30% robotic, and 21% laparoscopic. Component separation was performed in 16%. The median length of stay was 0.0, and the median number of 90-day outpatient postoperative visits was 1.0. The new Current Procedural Terminology coding system was associated with a higher median 90-day work relative value units per case (14.1) than the previous system (13.8) (P = .002). Subset analysis identified statistically higher median 90-day work relative value units per case using the new versus previous Current Procedural Terminology codes for hernias with the largest defect dimension >10 cm (23.3 vs 18.8), umbilical/epigastric/Spigelian hernias (9.2 vs 7.1), recurrent hernias (20.1 vs 17.3) and open ventral hernia repairs (9.8 vs 7.1), all P < .05. Median 90-day work relative value units per case were statistically lower using the new versus previous codes for non-recurrent (11.6 vs 13.8) and incarcerated/strangulated (14.8 vs 14.9) hernias, all P < .05. In the new coding system, postoperative care within 90-days contributed to a median of 1.3 work relative value units per case (9% of total 90-day work relative value units). ConclusionWe forecast that in our practice, the 2023 ventral hernia repair Current Procedural Terminology changes will result in a modest impact on clinical productivity. The impact of these changes on a particular practice depends on surgical practice patterns and ventral hernia case mix.

Acil inguinal hernilerde cerrahi yaklaşıma etki eden faktörler: Tek merkez deneyimi

Objective&#x0D; The aim is to establish the principles of surgery for patients who have undergone emergency groin hernia surgery by examining risk factors, diagnostic modalities, time to operation, and surgical techniques.&#x0D; Methods&#x0D; A retrospective analysis was conducted on patients who underwent groin hernia repair surgery between the years 2017 and 2022. The study evaluated various parameters such as demographic characteristics, physical examination findings, co-morbidities, radiologic assessments, operation notes, time of arrival to the hospital, and the duration of the operation. Data was collected from the hospital's electronic medical records system. Based on the mode of pre-operative assessment, patients were classified into two groups: group 1, comprising patients whose decision for surgery was based on physical examination alone, and group 2, comprising patients who underwent radiologic assessment prior to the operation.&#x0D; Result&#x0D; The risk evaluation of patients who underwent emergent hernia surgery revealed a higher incidence of women gender (25%) and femoral hernia type (16.6%) as compared to the elective surgery group, where the incidence was 6.7% and 1.6%, respectively. The diagnosis of patients was primarily based on physical examination findings, although radiologic methods were used preoperatively in 75% of the cases. It was observed that radiologic assessments increased the duration of the operation and resulted in higher morbidity and intestinal resection rates.&#x0D; Conclusion&#x0D; Radiologic methods, apart from in cases of suspected conditions such as obesity and recurrent hernias, may lead to delayed treatment and increased morbidity and mortality rates in patients undergoing emergent hernia surgery. Prompt surgical intervention based on physical examination findings is crucial in cases of strangulation or incarceration. In instances of spontaneous reduction, incisional exploration, hernioscopy, laparoscopy, or laparotomy should be considered if there is any suspicion of intestinal viability.

Effects of Spinal Deformities on Hiatal Hernia Occurrence and Recurrence

BackgroundSpinal deformities such as kyphosis, lordosis, and scoliosis have demonstrated a possible association between these deformities. Our hypothesis is that the presence of spinal deformities will increase the risk of hiatal hernia recurrence after repair. MethodsThe following data was retrospectively gleaned for patients undergoing hiatal hernia repair (1997–2022): age, sex, date of hiatal hernia repair, presence and type of spinal deformity, Cobb angle, type of hiatal hernia and size, type of hiatal hernia repair, recurrence and size, time to recurrence, reoperation, type of reoperation, and time to reoperation. ResultsSpinal deformities were present in 15.8% of 546 patients undergoing hiatal hernia repair, with a distribution of 21.8% kyphosis, 2.3% lordosis, 58.6% scoliosis, and 17.2% multiple. There was no difference in sex or age between groups. Spinal deformity patients were more likely to have types III and IV hiatal hernias (52.3% vs. 38.9%, p = 0.02) and larger hernias (median 5 [3-8] vs. 4 [2-6], p = 0.01). There was no difference in access, fundoplication use, or mesh use between groups. However, these patients had a higher recurrence rate (47.7% vs 30.0%, p = 0.001) and a shorter time to recurrence (months) (10.3 [5.6-25.1] vs 19.2 [9.8-51.0], p = 0.02). Cobb angle did not affect recurrence. ConclusionsSpinal deformity patients were more likely to have more complex and larger hiatal hernias. They were at higher risk of hiatal hernia recurrence after repair with shorter times to recurrence. This is a group that requires special attention with additional preoperative counseling and possibly use of surgical adjuncts in repair.

Genetic analyses identify evidence for a causal relationship between Ewing sarcoma and hernias

Knowledge of Ewing sarcoma (EWS) risk factors is exceedingly limited; however, multiple small, independent studies have suggested a possible connection between hernia and EWS. By leveraging hernia summary statistics from the UK Biobank and a recently published genome-wide association study of EWS (733 EWS cases and 1,346 controls), we conducted a genetic investigation of the relationship of 5 hernia types (diaphragmatic, inguinal, umbilical, femoral, and ventral) and EWS. We discovered a positive causal relationship between inguinal hernia and EWS (OR 1.27, 95% confidence interval [CI] 1.01-1.59, and p= 0.041) through Mendelian randomization analysis. Further analyses suggested shared pathways through three genes: HMGA2, LOX, and FBXW7. Diaphragmatic hernia showed a stronger causal relationship with EWS among all of the hernia types (OR 2.26, 95% CI 1.30-3.95, p= 0.004), but no statistically significant local correlation pattern was observed. No evidence of a causal or genetic relationship was observed between EWS and the other three hernia types, including umbilical hernia, despite a previous report indicating an OR as high as 3.3. The finding of our genetic analysis provided additional support to the hypothesis that EWS and hernias may share a common origin.

Parahiatal hernia: A rare type of hernia and the answer to an anatomical challenge

Parahiatal hernias are rare. They are difficult to diagnose preoperatively, as the clinical symptoms may be similar to hiatal and paraoesophageal hernias. Here, we report two cases of parahiatal hernia that were preoperatively diagnosed and successfully repaired laparoscopically; using the particular anatomic characteristics of this hernia, we also review the controversial oesophageal hiatal anatomy, as the surgical community often refers to the left bundle of the right crus as the left crus. There is no consensus on the indication or surgical technique to repair them. The first case is a 59-year-old woman with non-specific abdominal symptoms, in whom the preoperative gastroscopy and computed tomography (CT) raised the suspicion for parahiatal hernia. The second case is a 68-year-old woman who presented to the emergency department with abdominal distention and nausea, but no vomiting. Preoperative CT raised the suspicion of an incarcerated parahiatal hernia. Both patients underwent laparoscopic repair of the parahiatal hernia and a Toupet fundoplication. They had an uneventful postoperative course. After more than 4 years of follow-up, they are both asymptomatic. Parahiatal hernias are a rare form of diaphragmatic hernia that occur through a diaphragmatic defect lateral to an anatomically normal oesophageal hiatus, with herniation of contents between the left portion of the right crus and the left crus. Up to five different anatomical variations have been described. The knowledge of these anatomical variations has an impact on the type of surgical repair that will need to be performed if a parahiatal hernia is found.

Indocyanine Green Fluorescent Lymphography During Open Inguinal Hernia Repair: Relationship Between Lymphatic Vessel Injury and Postoperative Hydrocele.

This prospective case series analyzed patients who underwent indocyanine green (ICG) fluorescent lymphography during open inguinal hernia repair. The aim of this study was to investigate the association between ICG leakage and postoperative hydroceles in patients who underwent inguinal hernia repair. Data were analyzed from 40 patients who underwent primary open hernia repair between October 2020 and June 2021 (44 cases in total). Hydroceles were categorized into two types: symptomatic and "ultrasonic" (detected only by ultrasound imaging). In the univariate analysis, hernia type (p = 0.044) and ICG leakage (p = 0.007) were independent risk factors for postoperative ultrasonic hydroceles. Additionally, mesh type (p = 0.043) and ICG leakage (p = 0.025) were independent risk factors for postoperative symptomatic hydroceles. In the multivariate analysis, ICG leakage (p = 0.034) was an independent risk factor for postoperative ultrasonic hydroceles. ICG leakage after inguinal hernia repair was independently associated with postoperative ultrasonic and symptomatic hydroceles. These findings suggest a relationship between lymphatic vessel injury and the incidence of postoperative hydroceles.

Incidental finding of Bochdalek hernia in an adult: acasereport.

A Bochdalek hernia, also known as a congenital diaphragmatic hernia (CDH), is a type of hernia that occurs in infants. The diaphragm, the muscle that separates the chest cavity from the abdominal cavity, is characterized by a hole or gap during birth. This opening allows the abdominal organs, such as the stomach, intestines, or liver, to pass through the thoracic cavity. Here, we report a 56-year-old male patient who came to our hospital because of rectal bleeding, symptoms unrelated to the hernia. We performed a Computed Tomography (CT) scan with contrast enhancement to find the cause of the bleeding and as an incidental finding we diagnosed the hernia: it is very rare to find a silent Bochdalek hernia for more than 50 years.

Obturator Hernia is an Extremely Rare Type of Hernia with Relatively High Mortality and Morbidity

OBTURATOR HERNIA IS A RARE CONDITION IN WHICH ABDOMINAL CONTENTS PROTRUDE THROUGH THE OBTURATOR CANAL OBTURATOR HERNIAS HAVE BEEN REPORTED FOR 0.05% -1.4% OF ALL HERNIAS REFERRED TO AS THE “ LITTLE OLD LADY’S HERNIA “, OBTURATOR HERNIA IS MORE COMMON IN ELDERLY FEMALES AND POST PREGNANCY PATIENTS DUE TO THE GREATER WIDTH OF THE PELVIS, LARGER OBTURATOR CANAL, AND INCREASED LAXITY OF THE PELVIC TISSUES THE SYMPTOMS ARE USUALLY SIGNS OF PARTIAL BOWEL OBSTRUCTION AND ABDOMINAL PAIN THAT IS REFERRED ALONG THE OBTURATOR NERVE TO THE KNEE ( HOWSHIP – RHOMBERG SIGN ). A CT SCAN OF THE PELVIS AND UPPER THIGH REGION CAN BE HELPFUL AS A DIAGNOSTIC TOOL THE ONLY TREATMENT FOR OBTURATOR HERNIA IS SURGERY