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Review
. 2020 Sep 15;13(9):e235644.
doi: 10.1136/bcr-2020-235644.

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

Tharun Ganapathy Chitrambalam  1 , Pradeep Joshua Christopher  2 , Jeyakumar Sundaraj  2 , Sundeep Selvamuthukumaran  2
Affiliations
Review

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

Tharun Ganapathy Chitrambalam et al. BMJ Case Rep. .

Abstract

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.

Keywords: gastrointestinal surgery; general surgery; groin pain; small intestine; ultrasonography.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT image depicting groin defect with overcrowding of bowel loops.
Figure 2
Figure 2
Hernial orifice filling with CO2 after insufflation with veress needle.
Figure 3
Figure 3
Obturator and inguinal defects with perforated ileum on laparotomy after adhesiolysis.
Figure 4
Figure 4
Picture taken after obturator defect closure, while closure of inguinal defect is in process as labelled in figure.
See this image and copyright information in PMC

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