OBTURATOR HERNIAS

Abstract Introduction Obturator hernias are an extremely rare cause of bowel obstruction. This type of hernia accounts for 0.5% to 1.4% of all hernias. In addition to the rarity of this type of hernia, there is no standard approach to its management. Case Presentation The case of an 88-year-old woman with a 24-hour history of intestinal obstruction is presented. A CT scan showed a strangulated obturator hernia of the right ileum. Laparotomy confirmed the presence of a right obturator hernia with ileal strangulation. A segmental enterectomy with primary anastomosis and reduction of the hernia sac with mesh was performed to close the obturator foramen. Discussion Due to the non-specific symptoms, the diagnosis of this type of hernia is usually challenging and its treatment is only surgical. It often occurs in older, multiparous and emaciated women. Risk factors include weight loss, chronic lung disease and ascites, which increases abdominal pressure. A rare presenting sign is a palpable mass or the Howship-Romberg sign (pain radiating from the inner thigh and knee). Computed tomography has a higher sensitivity and accuracy than other radiological investigations for assessing the presence of an obturator hernia. Conclusion Obturator hernia is a rare type of hernia due to its often unclear diagnosis; a rapid suspicion based on non-specific symptoms is crucial for diagnosis. Surgical management is the only possible treatment for this pathology and depends on early diagnosis.