J Korean Surg Soc.  2010 Jan;78(1):41-50. 10.4174/jkss.2010.78.1.41.

Experiences on Obturator Hernia and Review of Korean Cases

• Heo SC
• Kang SB
• Chung JK
• Hwang KT
• Seungbum R
• Lee TG
• Park KJ

• KMID: 1775444
• DOI: http://doi.org/10.4174/jkss.2010.78.1.41

Abstract

PURPOSE: We performed this study to share experiences in the management of obturator hernia, which is a very rare disease among elderly women, because rarity of this disease will not approve an expert institute or surgeon and because the aging society, Korea, can increase the incidence.
METHODS
Patient characteristics, clinical manifestations and treatment results were retrospectively collected from the 12 obturator hernia patients since 2000 in the three hospitals of the authors. Twenty-one obturator hernia cases reported in the Korean literatures were reviewed. In addition, we analyzed clinical features and treatment results of the total 33 patients, collectively.
RESULTS
Most of the patients were elderly women except one young, poorly nourished, male patient with pulmonary tuberculosis. Their mean age was 79.6 years. Sixty-four percent (21/33) of the patients had preoperative morbidity. Symptoms from the compression of the obturator nerve, which is an important clue to the diagnosis, were observed in 67% (22/33). Interestingly, spontaneous or suspicious-spontaneous reductions were reported in 7 (21%) patients. Abdominal CT scan was the major tool for diagnosis. Abdominal approach alone could successfully manage most cases, though 84% (27/32) needed anastomosis of the bowel. Operative mortality was 2 of the 32 cases but morbidity was 44% of the 32 patients and the mean hospital period after operation was 21 days.
CONCLUSION
Management of patients with obturator hernJd surgical management and proper peri-operative care as well as appropriate managing the families is essential for improved results.

Keyword

Obturator hernia; Mortality; Morbidity

MeSH Terms

Aged
Aging
Female
Hernia, Obturator
Humans
Incidence
Korea
Male
Obturator Nerve
Rare Diseases
Retrospective Studies
Tuberculosis, Pulmonary

Figure

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  Fig. 1 Abdominal CT scan of obturator hernia. (A) Small bowel segment heniates through left obturator canal. (B) Herniated bowel is incarcerated between pectineus and external obturator muscle.

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  Fig. 2 Operative findings of strangulated hernia. (A) Small bowel is herniated and incarcerated through obturator canal. (B) Strangulated bowel segment is reduced and torn. (C) Hernia sac is inverted for repair.

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