J Korean Surg Soc.  2009 Sep;77(3):211-215. 10.4174/jkss.2009.77.3.211.

Successfully Treated Obturator Hernia in Spite of Delayed Operation

• Hwang KT
• Chung JK
• Jung IM
• Heo SC
• Ahn YJ
• Chang MS

• KMID: 2004222
• DOI: http://doi.org/10.4174/jkss.2009.77.3.211

Abstract

Obturator hernia is a rare type of pelvic hernia and occurs most commonly in elderly and debilitated women. It is still a challenge for surgeons to diagnose precisely in early stages because of its nonspecific symptoms and consequently delayed diagnosis could lead to high morbidity and mortality. We experienced a 92-year old patient who was diagnosed as obturator hernia which was confirmed by computed tomography scan of the abdomen and pelvis. The operation was delayed due to the refusal of family members but eventually done after 12 days from initial diagnosis. After manual reduction of small bowel impacted into right obturator foramen, segmental resection of impacted small bowel and anastomosis was done. The hernial defect was closed by primary closure with Dexon suture material. After the operation, the patient was discharged without significant complications. We report here successful results of delayed operation for obturator hernia.

Keyword

Obturator hernia; Obturator foramen

MeSH Terms

Abdomen
Aged
Benzenesulfonates
Delayed Diagnosis
Disulfiram
Female
Hernia
Hernia, Obturator
Humans
Pelvis
Sutures
Benzenesulfonates
Disulfiram

Figure

• 

  Fig. 1 (A) A plain abdominal film in the supine position reveals multiple dilated loops of small intestine. (B) A film in the upright position shows multiple dilated loops with air-fluid levels.

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  Fig. 2 Computed tomography scan of the abdomen and pelvis demonstrates a fluid-filled, low-density mass located between the right pectineus muscle and the external obturator muscles (arrow).

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  Fig. 3 Operative field of the right obturator foramen region. (A) Incarcerated small bowel at right obturator foramen is observed. (B) The hernia sac in the right obturator canal is noted with tip of forceps. (C) After segmental resection and anastomosis of impacted small bowel, hernia defect is repaired by primary suture.

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