Obturator hernia: A diagnostic challenge

Kulkarni, Sanjeev R.; Punamiya, Aditya R.; Naniwadekar, R. G.; Janugade, Hemant B.; Chotai, Tejas D.; Singh, Telvinderjit; Natchair, Arafath

doi:10.1016/j.ijscr.2013.02.023

Cited by 38 publications

(52 citation statements)

References 6 publications

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“…It contains the obturator nerve and vessels. The canal is 2-3 cm long and 1 cm wide, and it is usually filled with fat, allowing no space for a hernia [4]. The fat disappears in patients who have massive body weight loss or are very thin.…”

Section: Discussionmentioning

confidence: 99%

Strangulated Obturator Hernia: Difficult Diagnosis

Asma¹,

Youssef²,

Ridouan³

2017

UCMS

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Abstract:The obturator hernia is rare and its diagnosis is frequently missed. It is a rare cause of intestinal obstruction. Patients present with few clinical signs to identify the cause, apart from symptoms of intestinal obstruction. Therefore, obturator hernias are often diagnosed at laparotomy with a high motality rate. CASE REPORT: We recently encountered this lesion in a 75 year old woman presented with a history of right iliac fossa pain, bilious vomiting, abdominal distension. Non-specific findings on examination and blood tests made the diagnosis difficult, however, a CT scan of her abdomen revealed the site of the obstruction and the patient was taken to theatre for emergency surgery. She underwent a midline laparotomy and resection and anastomosis of small bowel and repair of the strangulated right obturator hernia. She presented a tachyrdia six days after surgery. The patient died of peritonitis postoperative (anastomotic dehiscence). The high mortality rate associated with this type of abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and prompt surgical intervention if the survival rate is to be improved.

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Section: Discussionmentioning

confidence: 99%

Strangulated Obturator Hernia: Difficult Diagnosis

Asma¹,

Youssef²,

Ridouan³

2017

UCMS

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“…According to Kulkarni et al, CT scan has superior sensitivity and accuracy compared with other noninvasive diagnostic tools. [3] Early diagnosis of obturator hernia prevents complications such as strangulation and perforation, and thereby reduces mortality and morbidity. As result of diagnostic difficulty, frequently intestinal segment has been ischemic for a long time and can easily be perforated when reducing it from the hernia sac.…”

Section: Case Reportmentioning

confidence: 99%

Obturator Hernia Should Be Considered In The Differential Diagnosis of Hip and Knee Pain

Belli

Memiş²,

Dere³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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Obturator hernia is a rare disease usually occurring in debilitated elderly women. Pain radiating down the medial thigh and knee (Howship-Romberg sign) is a specific sign of the disease. Presently described is a case of obturator hernia in a 73-year-old female patient who presented with severe left hip pain radiating down the medial thigh and knee, nausea, and loss of appetite. Initially, vertebral disc herniation was thought to be cause, but abdomino-pelvic computed tomography scan revealed left strangulated obturator hernia. Diagnosis of obturator hernia can be challenging. Physicians should consider obturator hernia in the differential diagnosis of knee and hip pain, and investigate for Howship-Romberg sign. Early diagnosis of the disease not only decreases morbidity and mortality, but also presents opportunity to treat with minimally invasive methods.

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“…Because it presents without any clear signs or symptoms, unless a computed tomography (CT) scan is performed, it is difficult to diagnose; therefore, surgical intervention in the early stages rarely occurs [4,5]. Here we present an atypical case of a femoral abscess, which was not suspected to be associated with OH, but at autopsy it was revealed to be the result of an OH perforation.…”

Section: Introductionmentioning

confidence: 99%

Richter’s Type of Incarcerated Obturator Hernia that Presented with a Deep Femoral Abscess: An Autopsy Case Report

et al. 2016

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Patient: Female, 89Final Diagnosis: Obturator herniaSymptoms: Coxalgia • femoral abscess • gait disorderMedication: —Clinical Procedure: —Specialty: SurgeryObjective:Unusual clinical courseBackground:Richter’s obturator hernia is a rare abdominal hernia that is difficult to diagnose. The purpose of this case report is to show an unusual presentation of a fatal Richter’s obturator hernia that was accompanied by a femoral abscess.Case Report:An 89-year-old woman complained of sudden left coxalgia and a gait disorder but no abdominal symptoms. She had no history of trauma or surgery in the inguinal area. Twenty-three days after her first complaint of coxalgia, the patient was admitted in a coma with necrotizing fasciitis in the left inguinal area. The patient died of asystole due to hyperkalemia. During surveillance for the cause of death, a Richter’s type of incarcerated obturator hernia was identified at autopsy. The incarcerated small intestine had penetrated into the left obturator foramen to form an abscess that extended into the deep femoral region.Conclusions:Obturator hernia accompanied by femoral abscess is extremely rare, but it should be suspected when a patient with no history of trauma or surgery has a femoral abscess, even in the absence of abdominal symptoms.

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Obturator hernia: A diagnostic challenge

Cited by 38 publications

References 6 publications

Strangulated Obturator Hernia: Difficult Diagnosis

Strangulated Obturator Hernia: Difficult Diagnosis

Obturator Hernia Should Be Considered In The Differential Diagnosis of Hip and Knee Pain

Richter’s Type of Incarcerated Obturator Hernia that Presented with a Deep Femoral Abscess: An Autopsy Case Report

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