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Review
. 2016 Jun 29:2016:bcr2016215428.
doi: 10.1136/bcr-2016-215428.

Difficult diagnosis: strangulated obturator hernia in an 88-year-old woman

Megan Kathleen Leitch  1 , Michael Yunaev  2
Affiliations
Review

Difficult diagnosis: strangulated obturator hernia in an 88-year-old woman

Megan Kathleen Leitch et al. BMJ Case Rep. .

Abstract

The obturator hernia is a rare type of hernia that can present a diagnostic challenge for the clinician. We report a case of an 88-year-old woman who presented with a history of right iliac fossa pain, bilious vomiting and diarrhoea. 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. We review the literature with focus on the diagnosis of obturator hernias and the different surgical approaches used. The authors believe that this case is of educational value to healthcare professionals, particularly those working in general practice, emergency departments and on surgical teams. It highlights to doctors that patients with incarcerated obturator hernias can present with or without overt signs of intestinal obstruction and emphasises the fact that an obturator hernia can be an important cause of intestinal obstruction in a thin, elderly woman.

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Figures

Figure 1
Figure 1
CT scan showing an obturator hernia on the right side (arrow).
Figure 2
Figure 2
Laparoscopic view of an obturator hernia (arrow).
Figure 3
Figure 3
Open view of an obturator hernia with a Pfannenstiel incision, with forceps pointing to the segment of ileum leading to the hernia.
See this image and copyright information in PMC

References

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