Little old lady’s hernia: a case of strangulated obturator hernia in a 88-year-old woman
Keywords:Obturator hernia, Howship-Romberg sign, Hannington-Kiff sign, Intestinal obstruction
Obturator hernia is an extremely rare type of hernia and an uncommon cause of intestinal obstruction. Diagnosing it represents a challenge due to the lack of specific signs and symptoms. The delay in establishing the diagnosis is responsible for its high rate of mortality. The patients are usually older, emaciated, small women. We presented a case of a small, thin, 88-year-old woman that came to our emergency department with a four-day history of lower abdominal pain, more intense in the left iliac fossa associated with anorexia and constipation. The diagnosis of the left obturator hernia was made intra-operatively. The small bowel, inside the obturator foramen, was necrotic so we made an enterotomy with primary repair of the hernia defect. The patient had post-operative ileus and left inguinal seroma. She was discharged on day 15 post-op with a good recovery. This case report is meant to be an alert for the difficulty of the obturated hernia diagnosis.
Hayes C, Schmidt K, Neduchelyn Y, Ivanovski I. Obturator hernia of Richter type: a diagnostic dilemma. BMJ Case Rep. 2020;13(12):e238252.
Li Z, Gu C, Wei M, Yuan X, Wang Z. Diagnosis and treatment of obturator hernia: retrospective analysis of 86 clinical cases at a single institution. BMC Surg. 2021;21(1):124.
Mercado M, Diab J, Loi K. A delayed diagnosis of obturator hernia hoodwinked by previous laparoscopic inguinal hernia repair. J Surg Case Rep. 2021;2021(9):rjab407.
Siddiqui Z, Khalil M, Khalil A, Saeed S. Obturator hernia: a delayed diagnosis. A case report with literature review. J Surg Case Rep. 2021;2021(1):rjaa599.
Meena SP, Vency AC, Badkur M, Lodha M. Left-Sided Strangulated Obturator Hernia: A Rare Case Report and Literature Review. Int J Appl Basic Med Res. 2021;11(3):198-200.
Barbosa BRDS, Pinto JCP, Duarte L, Marques J, Casimiro C. Small Bowel Obstruction Due to Incarcerated Obturator Hernia: Successfull Surgical Management with Modified Mesh-Plug Hernioplasty. Am J Case Rep. 2021;22:e931398.
Zhou YX, Ji Y, Lv J. Small bowel obstruction secondary to obturator hernia. ANZ J Surg. 2020;90(6):1195-7.
Major CK, Aziz M, Collins J. Obturator hernia: a case report. J Med Case Rep. 2021;15(1):319.
Hong Y, Zhang S, Kong X, Zhang Y, Hong S, Chen Y. Case report of ureter obturator hernia and literature review analysis. BMC Urol. 2021;21(1):86.
Mahendran B, Lopez PP. Obturator Hernia. StatPearls. Treasure Island, FL: StatPearls Publishing; 2022.