Obturator Hernia: A Diagnostic Challenge of Small-Bowel Obstruction

Liao, Chien-Feng; Hsu, Kuo-Feng; Liu, Chia-Chen; Chuang, Chu-Hsin

doi:10.1097/maj.0b013e3181bc2129

Cited by 15 publications

(13 citation statements)

References 10 publications

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“…They occur when the intestine protrudes through a defect in the obturator foramen and into the obturator canal, giving rise to a combined clinical picture of bowel obstruction with nausea, vomiting, abdominal pain, distension and weight loss,3 4 and in 15–50% of cases, anteromedial thigh pain (Howship-Rhomberg sign), caused by compression and irritation of the obturator nerve within the canal 5…”

Section: Discussionmentioning

confidence: 99%

‘Little old lady's hernia’ causing small bowel obstruction in a man: a case report with a review of literature on the pathophysiology of obturator hernias

Blach

Ghosh

2014

BMJ Case Reports

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Commonly known as 'little old lady's hernia', obturator hernias are usually seen in frail, octogenarian multiparous women reporting non-specific nausea and vomiting, abdominal pain and anteromedial thigh pain. They are exceedingly rare; even less frequently are they diagnosed preoperatively, with the vast majority being found incidentally at laparotomy for small bowel obstruction. This case report describes an atypical presentation of a 'little old lady's hernia' in a man, in whom, thanks to high degree of clinical suspicion, an incarcerated obturator hernia was diagnosed preoperatively and treated successfully.

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Section: Discussionmentioning

confidence: 99%

‘Little old lady's hernia’ causing small bowel obstruction in a man: a case report with a review of literature on the pathophysiology of obturator hernias

Blach

Ghosh

2014

BMJ Case Reports

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“…Since the use of CT scan, preoperative diagnosis rate was improved from 43% to 90% in some reports. 8 However, it is not always possible to diagnose all obturator hernias using CT of the abdomen as seen in our case. Diagnostic laparoscopy serves as a tool in diagnosing and treating occult, suspected and missed obturator hernias on imaging.…”

Section: Discussionmentioning

confidence: 71%

Diagnostic difficulties in obturator hernia: a rare case presentation and review of literature

et al. 2020

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Hernia arising from obturator canal is rare and it contributes to about less than 1% of incidence of all hernias. Diagnosing an obturator hernia clinically is a challenging one and nearly impossible. These hernias usually present as an intestinal obstruction as more than 50% of obturator hernias goes in for strangulation. Here, we report an unusual presentation of an obturator hernia in a 70-year-old woman who presented to emergency room with acute abdomen and uncomplicated reducible inguinal hernia. Radiological imaging showed obstructed inguinal hernia while on diagnostic laparoscopy, a strangulated and perforated obturator hernia of Richter’s type was seen in addition to an uncomplicated inguinal hernia. Obturator hernia, although very rare, is associated with high morbidity and mortality as it is often underdiagnosed as in our case. Laparoscopy bailed us out from missing out a perforation from an occult obturator hernia.

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“…However, the diagnostic capabilities of CT and MRI have become increasingly accurate [19,20] . In fact, a multidetector CT scan including pelvis has improved the preoperative diagnosis rate to 90% [21] since it was used to detect obturator hernia by…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment of Obturator Hernia: Retrospective Analysis of 86 Clinical Cases at a Single Institution.

Wei

et al. 2020

Preprint

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Background: To explore the clinical characteristics, diagnosis and treatment of obturator hernia.Methods: Eighty-six patients who were diagnosed as obturator hernia by abdominal CT in the Department of Gastrointestinal Surgery of our hospital between 2009 and 2019 were enrolled in this study. Patient characteristics, surgical method, postoperative complications and mortalities were retrospectively reviewed, and the patients were followed by telephone or clinic visit to check for the recurrence.Results: 30 days mortality rate of 5.5% and 46.1% were observed in surgery group and non-surgery group, respectively. Surgery was performed as an emergency procedure in 59 cases and elective procedure in 14 cases depending on different hernia contents, intestinal necrosis and signs of peritonitis. In the emergency surgery group, segmental intestinal resection with anastomosis was performed in 24 patients(24/59, 40.7%). There were 4 deaths(4/59, 6.8%) in this group ,all of which occurred in patients undergoing SI resections. In contrast, no bowel resection, postoperative complications, or death occurred in the elective surgery group. 3 -year recurrence rates of 5.1% (3/59)and 7.1%(1/14) were observed in the emergency surgery and the elective surgery group, respectively. Conclusions: CT examination plays an important role in improving the diagnostic rate of obturator hernia. In elderly people with comorbidities, timely surgical treatment is the key to improve the efficacy of obturator hernia and prevent the deterioration of the condition. In addition, postoperative mortality is significantly associated with bowel resection and postoperative complications.

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Obturator Hernia: A Diagnostic Challenge of Small-Bowel Obstruction

Cited by 15 publications

References 10 publications

‘Little old lady's hernia’ causing small bowel obstruction in a man: a case report with a review of literature on the pathophysiology of obturator hernias

‘Little old lady's hernia’ causing small bowel obstruction in a man: a case report with a review of literature on the pathophysiology of obturator hernias

Diagnostic difficulties in obturator hernia: a rare case presentation and review of literature

Diagnosis and Treatment of Obturator Hernia: Retrospective Analysis of 86 Clinical Cases at a Single Institution.

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