Background: In times of modern surgery, transplantation and percutaneous techniques, pyogenic liver

Laparoscopic lavage showed a high rate of successful sepsis control in selected patients with perforated Hinchey III acute diverticulitis affected by peritonitis, with low rates of operative mortality, reoperation and stoma formation.

The effectiveness of laparoscopic lavage seems to be high. Although its applicability is lower, it could be applied in more than half of patients requiring emergency surgery. This alternative strategy should be considered when laparoscopic assessment reveals Hinchey III diverticulitis.

Based on these results, the placement of intraperitoneal uncoated PPE mesh for elective IH repair might be a safe procedure that is not associated with ECF formation.

The end of 2019 was marked by the emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Our problem is centered in the post operative follow up of those patients who underwent an elective procedure immediately before the isolation and those who require an emergency surgery. We outline the measures we have taken to reduce the possibility of spread of the virus.

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ResumenIntroducción: La hernia obturatriz es una entidad poco frecuente, cuya incidencia oscila entre 0.05 % y el 1.5 %, con una morbimortalidad cercana al 40 %.Caso clínico: Mujer de 85 años, que comienza con náuseas, vómitos y distensión abdominal. Se realiza radiografía de abdomen y tomografía computarizada (tac), donde se observa hernia obturatriz izquierda. Se decide laparoscopia exploradora. Se reduce la hernia y se coloca malla de polipropileno preperitoneal.Discusión: La hernia obturatriz es una entidad poco frecuente, que se presenta en mujeres ancianas, multíparas y desnutridas. Su diagnóstico suele ser tardío, por lo que es una entidad con alta mortalidad, cercana al 40 %. La tomografía computarizada es el método diagnóstico por elección, y el abordaje laparoscópico, el tratamiento de primera opción.Conclusión: El objetivo principal en estos pacientes es realizar un diagnóstico precoz y poder, de esa manera, disminuir los índices de mortalidad. Ante la sospecha clínica, se solicitará tomografía computarizada de abdomen y pelvis, con la idea de no demorar la intervención quirúrgica. Key words:Obturator hernia, strangulation, intestinal obtruction, computed tomography Abstract Introduction: Obturator hernia is a rare entity whose incidence varies between 0.05 and 1.5%.Case report: Female of 85 years beginning with nausea, vomiting and abdominal distension. abdominal radiography and computed tomography, which left obturator hernia is observed is performed. Exploratory laparoscopy is decided; the hernia is reduced and preperitoneal polypropylene mesh is placed.Discussion: It is a rare entity that occurs in older, multiparous women and malnourished. His diagnosis is usually late, so it is an entity with high mortality, close to 40%. Computed tomography is the diagnostic method of choice and the laparoscopic approach the treatment of fi rst choice.Conclusion: The main objective in these patients is early diagnosis, and thus to reduce mortality rates. Clinical suspicion, abdomen and pelvis computed tomography requested, with the idea of not delaying surgery.