Howship-Romberg Sign and Bowel Obstruction: A Case Report

Saeed, Rasha; Ahmed, Mohamed A.; Lara, Gustavo; Mahmoud, Ahmed; Nurick, Harvey

doi:10.7759/cureus.5066

Cited by 9 publications

(4 citation statements)

References 8 publications

(7 reference statements)

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“…The management of this type of hernia is surgical repair as it is the gold standard. In the literature, obturator hernia repair is done as an open procedure, however, in our case, the surgery was initiated and completed as a laparoscopic procedure due to the advantage of shorter length of hospital stay, less postoperative pain and lower risk of complications [ 1 , 6 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

A case of intestinal obstruction in a 90-year-old patient at a tertiary hospital in Central Saudi Arabia with a rare cause: obturator hernia!

Sulaihim

Alsaadon

Alsuhaibani

et al. 2022

Journal of Surgical Case Reports

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Obturator hernia is a pelvic floor type of hernia in which abdominal or pelvic contents protrude through the obturator foramen. It is considered rare in patients with signs and symptoms of intestinal obstruction causing a diagnostic challenge for clinicians. This case reports a 91-year-old multiparous female who presented with vague lower abdominal pain associated with obstipation and vomiting. We present a successful laparoscopic repair of obturator hernia in an elderly female.

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Section: Discussionmentioning

confidence: 99%

A case of intestinal obstruction in a 90-year-old patient at a tertiary hospital in Central Saudi Arabia with a rare cause: obturator hernia!

Sulaihim

Alsaadon

Alsuhaibani

et al. 2022

Journal of Surgical Case Reports

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“…Although obturator hernia is relatively insidious, Howhip-Romberg sign is still important in the diagnosis of IOH, which is an indication of obturator nerve irritation resulting in pain radiates from the inner thigh to the knee, accounting for 37% to 60% of all patients. [11][12][13][14] In fact, CT examination is widely used for the diagnosis of IOH with an accuracy of over 90%, which is also considered the gold standard for diagnosis. 11,15,16 CT scan demonstrated incarcerated small bowel in obturator region with signs of proximal intestinal obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, IOH should also be highly suspected for intestinal obstruction in elderly women who are without abdominal surgery history. Although obturator hernia is relatively insidious, Howhip-Romberg sign is still important in the diagnosis of IOH, which is an indication of obturator nerve irritation resulting in pain radiates from the inner thigh to the knee, accounting for 37% to 60% of all patients 11–14. In fact, CT examination is widely used for the diagnosis of IOH with an accuracy of over 90%, which is also considered the gold standard for diagnosis 11,15,16.…”

Section: Discussionmentioning

confidence: 99%

The Feasibility and Potential Advantages of Laparoscopic Management of Incarcerated Obturator Hernia Over the Open Approach

Zhang

Yuan²,

Gu³

et al. 2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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The purpose of this study was to explore the feasibility and potential advantages of laparoscopic surgery in the treatment of incarcerated obturator hernia (IOH).Materials and Methods: Clinical data of 23 patients with IOH who underwent emergency surgery at our hospital from June 2015 to October 2020 were retrospectively analyzed. The clinical characteristics and surgery outcomes were compared between the laparoscopic group, open group, and the previously published data.Results: Twelve patients with IOH were treated by laparoscopic management, while 11 patients with IOH underwent open surgery. There was no statistically significant difference in preoperative general data between the 2 groups, while the laparoscopic group had less intraoperative blood loss, shorter postoperative hospital stay, and lower postoperative complications compared with open group. Furthermore, when compared with the open group reported in previous literature, which showed similar conclusions. Conclusion:Laparoscopic surgery for IOH showed more favorable advantages including less intraoperative blood loss, shorter postoperative hospital stay, and lower postoperative complications compared with an open approach, which is a safe and feasible minimally invasive strategy and has certain advantages.

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“…The etiologies of neuropathy include trauma, iatrogenic injury from pelvic surgery, mass effect from space occupying lesions such as tumors, obturator hernias, and in rare cases an acetabular paralabral cyst (26)(27) . The Howship-Romberg sign is defined as inner-thigh pain with internal rotation of the hip, which clinically indicates obturator neuropathy in the setting of an obturator hernia (28) .…”

Section: Obturator Nervementioning

confidence: 99%

The role of high-resolution ultrasound and MRI in the evaluation of peripheral nerves in the lower extremity

Lee,

Serhal,

Serhal

et al. 2023

J Ultrason

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Lower extremity peripheral neuropathy is a commonly encountered neurologic disorder, which can lead to chronic pain, functional disability, and decreased quality of life for a patient. As diagnostic imaging modalities have improved, imaging has started to play an integral role in the detection and characterization of peripheral nerve abnormalities by non-invasively and accurately identifying abnormal nerves as well as potential causes of neuropathy, which ultimately leads to precise and timely treatment. Ultrasound, which has high spatial resolution and can quickly and comfortably characterize peripheral nerves in real time along with associated denervation muscle atrophy, and magnetic resonance neurography, which provides excellent contrast resolution between nerves and other tissues and between pathologic and normal seg- ments of peripheral nerves, in addition to assessing reversible and irreversible muscle denervation changes, are the two mainstay imaging modalities used in peripheral nerve assessment. These two modalities are complimentary, and one may be more useful than the other depending on the nerve and location of pathol- ogy. Imaging must be interpreted in the context of available clinical information and other diagnostic stud- ies, such as electrodiagnostic tests. Here, we offer a comprehensive overview of the role of high-resolution ultrasound and magnetic resonance neurography in the evaluation of the peripheral nerves of the lower extremity and their associated neuropathies.

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Howship-Romberg Sign and Bowel Obstruction: A Case Report

Cited by 9 publications

References 8 publications

A case of intestinal obstruction in a 90-year-old patient at a tertiary hospital in Central Saudi Arabia with a rare cause: obturator hernia!

A case of intestinal obstruction in a 90-year-old patient at a tertiary hospital in Central Saudi Arabia with a rare cause: obturator hernia!

The Feasibility and Potential Advantages of Laparoscopic Management of Incarcerated Obturator Hernia Over the Open Approach

The role of high-resolution ultrasound and MRI in the evaluation of peripheral nerves in the lower extremity

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