Strangulated obturator hernia: a case report with literature review

Abstract

Obturator hernia is rare. It occurs when part of the pelvic contents protrude through the obturator foramen. It is a diagnostic challenge in the emergency department since the signs and symptoms are non-specific. It often occurs in elderly, emaciated and chronically ill women. The clinical picture include intestinal obstruction with abdominal pain, nausea and vomiting. The treatment is only surgical. Delayed diagnosis of this condition usually leads to a high mortality rate. We report the case of an 83-year-old woman with a strangulated obturator hernia. The hernia was discovered early by computed tomography and was treated by emergency laparotomy. We emphasize on the rule of CT scan to establishing a prompt preoperative diagnosis of an obturator hernia, appropriate planning of surgical intervention and thus optimizing the outcome.

Keywords: CT scan; Hernia; bowel obstruction; obturator foramen.

Figure 1

(A) axial pelvic CT scan; (B,C) multiplanar reconstructed images through the left obturator canal, showed a dilated loop of small bowel (asterisk) upstream of a strangulated point (arrow) caused by a left obturator hernia (large arrow). Noted the collapsed loops down and colon (arrowhead)