Obturator hernia and the elderly

Gilbert, John D.; Byard, Roger W.

doi:10.1007/s12024-018-0046-z

Cited by 11 publications

(16 citation statements)

References 15 publications

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“…Obturator hernia, also known as "little old lady's hernia," is usually seen in thin, multiparous octogenarian (70-90 years) older woman. Although very rare, accounting for less than 1% of all intra-abdominal hernia, it has the highest mortality (13-70%) and is even often first identified at autopsy (Mandarry et al 2012;Gilbert and Byard 2019). Most patients present with nonspecific abdominal complaints, with over 90% presenting with subacute or acute intestinal obstruction: the vast majority are found only intra operatively.…”

Section: Herniamentioning

confidence: 99%

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Surgical Abdomen

Peláez¹,

Agarwal²

2020

Geriatric Gastroenterology

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Abdominal pain is a common and challenging problem in the geriatric population, characterized by severe pain that requires an urgent and specific diagnosis. A rapidly worsening prognosis is possible in absence of prompt intervention. The most common causes of acute abdomen in the older age group are acute cholecystitis, acute appendicitis, perforated peptic ulcer disease, acute pancreatitis, intestinal obstruction, ischemic bowel disease, diverticulitis, obstructed hernias and aortic aneurysm rupture. Symptoms and physical findings often

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Section: Herniamentioning

confidence: 99%

“…20). Prompt surgical intervention is indicated once the diagnosis is confirmed (Mandarry et al 2012;Blach and Ghosh 2014;Pavlidis et al 2018;Gilbert and Byard 2019).…”

Section: Herniamentioning

confidence: 99%

Surgical Abdomen

Peláez¹,

Agarwal²

2020

Geriatric Gastroenterology

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“…Obturator hernias are rare and account for less than 1% of all abdominal wall hernias [ 1 ]. These hernias have a high mortality rate due to their nonspecific signs and symptoms during presentation [ 2 ]. Common signs and symptoms include symptoms of bowel obstruction such as nausea, vomiting, and abdominal pain, along with pain in the groin or medial thigh.…”

Section: Introductionmentioning

confidence: 99%

Obturator hernia: a case report

2021

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Background Obturator hernia is rare and accounts for less than 1% of all abdominal wall hernias. It represents a diagnostic challenge due to its nonspecific signs and symptoms. Case presentation We present a case of an 89-year-old caucasian female with a 12-hour history of right medial thigh pain. Computed tomography scan revealed a right obturator hernia with small bowel obstruction. The hernia was successfully repaired laparoscopically without any need for small bowel resection. She was discharged on postoperative day 2 with an uneventful recovery and zero complications. Conclusion This case report highlights the importance of rapid diagnosis and repair of obturator hernia even in the setting of an improving clinical picture. It also demonstrates the safety of laparoscopic repair in this setting.

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“…Its incarceration is a rare cause of mechanical intestinal obstruction (0.2–1.6%) [ 3 , 4 ]. Obturator hernias have a higher incidence in elderly women (70–90%) [ 1 – 8 ] from Asian countries [ 4 , 5 ] and those who are malnourished [ 1 , 2 , 4 – 7 ] or multiparous [ 2 , 5 , 6 ]. This type of hernia has the highest morbidity and mortality rates of all abdominal wall hernias, with 70% mortality in complicated cases [ 1 , 5 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Obturator hernias have a higher incidence in elderly women (70–90%) [ 1 – 8 ] from Asian countries [ 4 , 5 ] and those who are malnourished [ 1 , 2 , 4 – 7 ] or multiparous [ 2 , 5 , 6 ]. This type of hernia has the highest morbidity and mortality rates of all abdominal wall hernias, with 70% mortality in complicated cases [ 1 , 5 , 7 ]. The hernia sac usually contains the small intestine; however, it may rarely contain the appendix, colon, Meckel’s diverticulum, or epiploon [ 2 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Small Bowel Obstruction Due to Incarcerated Obturator Hernia: Successfull Surgical Management with Modified Mesh-Plug Hernioplasty

et al. 2021

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Patient: Female, 93-year-old Final Diagnosis: Incarcerated obturator hernia Symptoms: Diffuse abdominal pain Medication:— Clinical Procedure: Hernioplasty Specialty: Surgery Objective: Rare disease Background: Obturator hernia is an uncommon (0.07-1% incidence rate) subtype of hernia of the abdominal wall, with its incarceration being a rare cause of bowel obstruction. Obturator hernia has a higher incidence in elderly women and in malnourished people. This type of hernia has the highest morbidity and mortality rates of all abdominal wall hernias. This article reports a case of an emaciated 93-year-old woman who presented with small bowel obstruction due to incarcerated obturator hernia, successfully managed surgically with a modified mesh-plug hernioplasty. Case Report: An emaciated 93-year-old woman presented with diffuse abdominal pain, more intense on the right iliac fossa, radiating to the right thigh, with 8-h evolution and associated with dark-colored vomiting but normal bowel transit. This patient had a surgical history of right Richter´s femoral hernia, strangulated, with previous intestinal resection and a right femoral hernioplasty. A computed tomography (CT) scan revealed an incarcerated obturator hernia on the right side containing a short segment of small intestine. The patient underwent an exploratory laparotomy and a mesh-plug hernioplasty. During follow-up, there was no evidence of recurrence or complications. Conclusions: Obturator hernia diagnosis is challenging due to its rarity and its signs and symptoms being often unspecific. CT scan has the highest sensitivity and is the best diagnostic tool. Surgical management is the only possible treatment for obturator hernia. Awareness of this condition is essential to allow an earlier approach and attempt to mitigate the associated high morbidity and mortality rates.

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Obturator hernia and the elderly

Cited by 11 publications

References 15 publications

Surgical Abdomen

Surgical Abdomen

Obturator hernia: a case report

Small Bowel Obstruction Due to Incarcerated Obturator Hernia: Successfull Surgical Management with Modified Mesh-Plug Hernioplasty

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