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Moritz AA, Glaser C, Eucker D, Rosenberg R. Incarcerated obturator hernia with a fistula to the adductor muscles: Case report of a rare hernia with uncommon symptoms, discovered by CT. Int J Surg Case Rep 2024; 121:109945. [PMID: 38936138 PMCID: PMC11261084 DOI: 10.1016/j.ijscr.2024.109945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/19/2024] [Accepted: 06/25/2024] [Indexed: 06/29/2024] Open
Abstract
INTRODUCTION Obturator hernias are rare, occur mainly in slender people and predominantly in females. Underlying pathology of the obturator hernia is a weakening of the obturator membrane. The obturator hernia is situated between the pubic and ischial bones and is therefore clinically occult. Patients predominantly present with symptoms of bowel obstruction, but can also present with sensory disturbance, leg pain and hip pain. Due to the usually delayed diagnosis, the obturator hernia is associated with increased morbidity and mortality. CASE PRESENTATION A 71-year-old female patient with hip pain underwent a protracted diagnostic work-up and was referred to the surgical department by the treating orthopedic surgeon. An incarcerated obturator hernia with a fistula in the adductor ligament was finally diagnosed via CT. The operation included laparoscopic reduction, hernia repair, open small bowel segment resection, local surgical exploration, lavage and antibiotic treatment. The primary hernia repair was performed by direct suture due to the contamination, and a post-primary mesh repair was indicated. However, after complete recovery and no remaining symptoms, the patient refused this despite the indication for definitive laparoscopic hernia repair. DISCUSSION Hip pain can have multiple causes. Taking physical characteristics into account can lead to the correct diagnostic pathway. The CT scan revealed the fistula which led to the laparoscopic surgery. Due to the intestinal damage and contamination, the surgical steps were adapted. CONCLUSION Obturator hernias should be considered as a reason for atypical symptoms in slender, older patients. Adequate surgical management can be chosen after correct diagnosis.
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Affiliation(s)
| | - Christine Glaser
- Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Dietmar Eucker
- Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Robert Rosenberg
- Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
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Salazar-Rios E, Cruz Olascoaga A. The "Little-Old-Lady's Hernia", Obturator Hernia: A Case Report and Literature Review. Case Rep Surg 2024; 2024:1039438. [PMID: 39015132 PMCID: PMC11250703 DOI: 10.1155/2024/1039438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/05/2024] [Accepted: 06/08/2024] [Indexed: 07/18/2024] Open
Abstract
Obturator hernias, though rare, are clinically significant abdominal hernias, predominantly affecting elderly, thin women, with an estimated prevalence of less than 1%. The primary treatment involves surgical intervention to reduce and repair the defect, either through laparotomy or laparoscopy, with bowel resection needed in up to 75% of patients. Here, we present the case of an 83-year-old woman presenting with abdominal pain and a history of constipation. An abdominal computed tomography scan demonstrated a left obturator hernia with small bowel obstruction. Successful reduction of the hernia was achieved, albeit requiring intestinal resection via an open surgical approach. Subsequently, the patient achieved complete recovery.
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Affiliation(s)
- Enrique Salazar-Rios
- División de Estudios de PosgradoFacultad de MedicinaUniversidad Nacional Autónoma de México, México City, Mexico
- Departamento de GastrocirugíaHospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez” Centro Médico Nacional Siglo XXIInstituto Mexicano del Seguro Social, México City, Mexico
| | - Alexa Cruz Olascoaga
- Unidad Médica de Alta EspecialidadHospital de Gineco Obstetricia No. 3 “Dr. Víctor Manuel Espinosa de los Reyes Sánchez” Centro Médico Nacional la RazaInstituto Mexicano del Seguro Social, México City, Mexico
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3
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Biller J, Silvis J, Duke D. Recurrent Obturator Hernia: A Rare Entity. Cureus 2024; 16:e53732. [PMID: 38455806 PMCID: PMC10919941 DOI: 10.7759/cureus.53732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Obturator hernias are rare with an incidence of less than 1% of all hernias and are most common in frail, elderly females. They are difficult to diagnose and even more difficult to repair. They often present with a small bowel obstruction from the incarcerated bowel. We report a case of a recurrent obturator hernia after a laparoscopic repair using a patch of omentum. The recurrence was repaired laparoscopically with a trans-abdominal preperitoneal repair (TAPP) with mesh. Given the rarity of the disease, there is scarce literature on the ideal method of repair, especially in patients with recurrence. However, with recent trends toward minimally invasive preperitoneal mesh hernia repairs for inguinal and ventral hernias, this type of repair should be strongly considered for patients with obturator hernias as well.
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Affiliation(s)
- Jessica Biller
- General Surgery, Conemaugh Memorial Medical Center, Johnstown, USA
| | - Jennifer Silvis
- Trauma and Acute Care Surgery, Conemaugh Memorial Medical Center, Johnstown, USA
| | - D'Arcy Duke
- Bariatric and Minimally Invasive Surgery, Conemaugh Memorial Medical Center, Johnstown, USA
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Holm MA, Baker JJ, Andresen K, Fonnes S, Rosenberg J. Epidemiology and surgical management of 184 obturator hernias: a nationwide registry-based cohort study. Hernia 2023; 27:1451-1459. [PMID: 37747656 DOI: 10.1007/s10029-023-02891-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE We aimed describe the patient characteristics, surgical details, postoperative outcomes, and prevalence and incidence of obturator hernias. Obturator hernias are rare with high mortality and no consensus on the best surgical approach. Given their rarity, substantial data is lacking, especially related to postoperative outcomes. METHODS The study was based on data from the nationwide Danish Hernia Database. All adults who underwent obturator hernia surgery in Denmark during 1998-2023 were included. The primary outcomes were demographic characteristics, surgical details, postoperative outcomes, and the prevalence and incidence of obturator hernias. RESULTS We included 184 obturator hernias in 167 patients (88% females) with a median age of 77 years. Emergency surgeries constituted 42% of repairs, and 72% were laparoscopic. Mesh was used in 77% of the repairs, with sutures exclusively used in emergency repairs. Concurrent groin hernias were found in 57% of cases. Emergency surgeries had a 30-day mortality of 14%, readmission rate of 21%, and median length of stay of 6 days. Elective surgeries had a 30-day mortality of 0%, readmission rate of 10%, and median length of stay of 0 days. The prevalence of obturator hernias in hernia surgery was 0.084% (95% CI: 0.071%-0.098%), with an incidence of one per 400,000 inhabitants annually. CONCLUSIONS This was the largest cohort study to date on obturator hernias. They were rare, affected primarily elderly women. The method of repair depends on whether the presentation is acute, and emergency repair is associated with higher mortality.
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Affiliation(s)
- M A Holm
- Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, DK, Denmark.
- Emergency Department, Nykøbing Falster Hospital, Ejergodvej 63, 4800, Nykøbing Falster, Denmark.
| | - J J Baker
- Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, DK, Denmark
| | - K Andresen
- Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, DK, Denmark
| | - S Fonnes
- Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, DK, Denmark
| | - J Rosenberg
- Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, DK, Denmark
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Nguyen MT, Nguyen VQ. Concurrent strangulated obturator hernia and femoral hernia repair via TAPP approach: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231185956. [PMID: 37539355 PMCID: PMC10395156 DOI: 10.1177/2050313x231185956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/16/2023] [Indexed: 08/05/2023] Open
Abstract
An obturator hernia is a rare pelvic hernia with high mortality. Early diagnosis and treatment are essential to reduce postoperative complications. The treatment of choice for obturator hernias is surgery. In an emergency, laparotomy to resolve herniated viscera and complications is often the choice. However, some researchers have shown the feasibility of laparoscopy. The laparoscopic approach has several benefits over the open approach, including reduced postoperative pain, early mobilization, shorter length of stay, and lower postoperative morbidity rates. We report the case of an 81-year-old woman with a right-side obstructed obturator hernia. The patient was hospitalized with an acute onset of inner thigh pain and bowel obstruction. The obturator hernia was diagnosed preoperatively by an abdominopelvic CT scan with the image of protrusion of an ileal loop in the right obturator foramen. The patient was treated by an emergency laparoscopy. The right obturator hernia and a concurrent right femoral hernia were confirmed during the operation. The hernia defect was repaired with a mesh large enough to cover all hernia foramen. The patient recovered without any complications. Emergency laparoscopic repair for obstructed obturator hernia was safe and effective.
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Affiliation(s)
- Minh Thao Nguyen
- Digestive Surgery Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Thua Thien Hue, Vietnam
| | - Van Quy Nguyen
- General Surgery Department, Franco-Vietnamese Hospital, Ho Chi Minh City, Vietnam
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Soukouli K, Dedopoulou P, Papatriantafyllou A, Karioris I, Leivaditis V, Tsochatzis S. Obturator Hernia in a 71-Year-Old Patient: A Diagnostic Challenge. Cureus 2023; 15:e42117. [PMID: 37602135 PMCID: PMC10436750 DOI: 10.7759/cureus.42117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
An obturator hernia is a relatively rare form of pelvic hernia, wherein abdominal organs protrude through an opening in the pelvis known as the obturator foramen. The majority of patients with this condition present to the emergency room with symptoms of bowel obstruction. Due to the non-specific nature of these symptoms, making a preoperative diagnosis of obturator hernia can be challenging. Any delay in the diagnosis and treatment of this condition can lead to a significant risk of mortality. In this report, we present the case of a 71-year-old patient who presented to the emergency department complaining of lower abdominal pain and nausea. An abdominal X-ray revealed bowel dilation, and based on the patient's symptoms, a diagnosis of bowel obstruction was suspected. A CT scan of the abdomen and pelvis was performed to investigate the reason for bowel dilation, and the existence of an obturator hernia was confirmed.
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Affiliation(s)
| | | | | | | | - Vasileios Leivaditis
- Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, DEU
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7
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Burla MM, Gomes CP, Calvi I, Oliveira ESC, Hora DAB, Mao RD, de Figueiredo SMP, Lu R. Management and outcomes of obturator hernias: a systematic review and meta-analysis. Hernia 2023:10.1007/s10029-023-02808-w. [PMID: 37270718 DOI: 10.1007/s10029-023-02808-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/21/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE Obturator Hernia (OH) is a rare type of abdominal wall hernia. It usually occurs in elderly women with late symptomatic presentation, increasing mortality rates. Surgery is the standard of care for OH, and laparotomy with simple suture closure of the defect is commonly used. Given the rarity of this disease, large studies are lacking, and data to drive management are still limited. This systematic review and meta-analysis aimed to describe current surgical options for OHs, with a focus on comparing the effectiveness and safety of mesh use with primary repair. METHODS PubMed, EMBASE, and Cochrane were searched for studies comparing mesh and non-mesh repair for OH. Postoperative outcomes were assessed by pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. RESULTS One thousand seven hundred and sixty studies were screened and sixty-seven were thoroughly reviewed. We included 13 observational studies with 351 patients surgically treated for OH with mesh or non-mesh repair. One hundred and twenty (34.2%) patients underwent mesh repair and two hundred and thirty-one (65.81%) underwent non-mesh repair. A total of 145 (41.3%) underwent bowel resection, with the majority having a non-mesh repair performed. Hernia recurrence was significantly higher in patients who underwent hernia repair without mesh (RR 0.31; 95% CI 0.11-0.94; p = 0.04). There were no differences in mortality (RR 0.64; 95% CI 0.25-1.62; p = 0.34; I2 = 0%) or complication rates (RR 0.59; 95% CI 0.28-1.25; p = 0.17; I2 = 50%) between both groups. CONCLUSION Mesh repair in OH was associated with lower recurrence rates without an increase in postoperative complications. While mesh in clean cases is more likely to offer benefits, an overall recommendation regarding its use in OH repair cannot be made due to potential bias across studies. Given that many OH patients are frail and present emergently, the decision to use mesh is complex and should consider the patient's clinical status, comorbidities, and degree of intraoperative contamination.
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Affiliation(s)
- M M Burla
- Department of Medicine, Estacio de Sa Vista Carioca University, RJ, Rio de Janeiro, Brazil.
| | - C P Gomes
- Department of Obstetrics and Gynecology, Maimonides Medical Center, New York, NY, USA
| | - I Calvi
- Department of Medicine, Immanuel Kant Baltic Federal University, Kaliningrad, KGD, Russian Federation
| | - E S C Oliveira
- Department of Medicine, University of Brasilia, Brasilia, DF, Brazil
| | - D A B Hora
- Department of Medicine, Federal University of Amazonas, Manaus, AM, Brazil
| | - R D Mao
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - S M P de Figueiredo
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - R Lu
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
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Bohara S, Karki S, Gautam A, Regmi BU, Rimal S, Khadka L, Pokharel A, Gurung B, Rawal SB. Obturator hernia (the little old lady's hernia) diagnosed via computed tomography: a case report. Ann Med Surg (Lond) 2023; 85:1282-1285. [PMID: 37113834 PMCID: PMC10129172 DOI: 10.1097/ms9.0000000000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Obturator hernia is an infrequent clinical entity of abdominal wall hernia, accounting for an incidence rate ranging from 0.073 to 2.2% of all hernias and being responsible for 0.2-1.6% of all cases of mechanical intestinal obstruction. The computed tomography (CT) scan, as an imaging modality, is critical in improving the diagnostic rate of obturator hernia. Case presentation The authors herein report an 87-year-old thin male patient with a known history of chronic obstructive pulmonary disease who presenting with complaints of abdominal pain for 3 days and constipation for 2 days, as well as one episode of vomiting without any features of peritoneal irritation, which was diagnosed early as a right-sided obturator hernia via CT and managed with exploratory laparotomy with hernia reduction and polypropylene mesh repair. Discussion Obturator hernia is a rare surgical phenomenon with a varied clinical spectrum, ranging from asymptomatic to presenting as intestinal obstruction. The CT scan plays a critical role in the detection of obturator hernias, which ameliorates the possible significant postoperative morbidity and mortality. Conclusion This report demonstrates that a high index of suspicion combined with CT imaging aids in early diagnosis and management, thus overcoming the reluctant morbidity.
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Affiliation(s)
- Sujan Bohara
- Departments of General and Gastrointestinal Surgery
- Corresponding author. Address: Department of General and Gastrointestinal Surgery, Nepal Mediciti Hospital, Lalitpur 44700, Nepal. Tel.: 9779860103009. E-mail: (S. Bohara)
| | | | - Anu Gautam
- Nepalese Army Institute of Health Sciences, Kathmandu
| | | | | | | | - Anuj Pokharel
- Nepalese Army Institute of Health Sciences, Kathmandu
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Anderson T, Bessoff KE, Spain D, Choi J. Contemporary management of obturator hernia. Trauma Surg Acute Care Open 2022; 7:e001011. [PMID: 36213131 PMCID: PMC9535161 DOI: 10.1136/tsaco-2022-001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Kovi E Bessoff
- Surgery, University of California Davis, Sacramento, California, USA
| | - David Spain
- Surgery, Stanford University, Stanford, California, USA
| | - Jeff Choi
- Surgery, Stanford University, Stanford, California, USA
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10
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Doden K, Yoshimura T, Shibata S, Kimura K, Iwaki Y, Kawaguchi M, Kato H, Watanabe T. Laparoscopic transabdominal preperitoneal repair for recurrent obturator hernia initially treated by open mesh plug repair: A case report with video. Asian J Endosc Surg 2022; 15:816-819. [PMID: 35534991 DOI: 10.1111/ases.13076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/26/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022]
Abstract
An 80-year-old woman presented to our emergency department with vomiting which had begun half a day prior to presentation. She had undergone open mesh plug repair for a right obturator hernia 1 year prior to presentation. Computed tomography detected recurrence of the right obturator hernia. Since intestinal viability was maintained, manual reduction of the incarcerated intestine was performed. The patient was admitted to our department to monitor delayed intestinal perforation. Laparoscopic transabdominal preperitoneal repair for obturator hernia was performed 5 days after admission. A self-fixating mesh was placed over the obturator hernia defect and femoral ring without tacking. The patient was discharged on postoperative day 6 without postoperative complications. At the 4-month follow-up, no signs of hernia recurrence or neuropathy were observed. Laparoscopic transabdominal preperitoneal repair for recurrent obturator hernia status post-open mesh plug repair by using self-fixating mesh is a safe and suitable procedure.
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Affiliation(s)
- Kenta Doden
- Department of Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | | | - Shiori Shibata
- Department of Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Karin Kimura
- Department of Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Yoshitaka Iwaki
- Department of Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | | | - Hideaki Kato
- Department of Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Toru Watanabe
- Department of Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
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Mizuno R, Takeuchi G, Ueda Y, Nomura Y, Nakamura S, Omori A, Ganeko R, Hashimoto K, Kubota Y, Nagayama S. A case of acute appendicitis incarcerated in obturator hernia. Clin J Gastroenterol 2022; 15:941-945. [PMID: 35902487 DOI: 10.1007/s12328-022-01681-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/19/2022] [Indexed: 10/16/2022]
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12
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Khalifa MB, Maatouk M, Ghannouchi M, Hammouda S, Nacef K, Boudokhane M. Obturator hernia: A case report of intestinal obstruction with challenging diagnosis and non-standardized treatment. Int J Surg Case Rep 2022; 94:107016. [PMID: 35421725 PMCID: PMC9019259 DOI: 10.1016/j.ijscr.2022.107016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/22/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction and importance Obturator Hernia (OH) is a rare clinical entity that constitue less than 1% of all abdominal hernias. It happens in elderly thin women malnourished. The diagnosis is usually delayed because symptoms are non-specific, and patients commonly have features of intestinal obstruction. There are no international guidelines for treatment and the best surgical approach still unknown. Case presentation We report a case of strangulated OH in a 75 year woman who consulted in our service for an acute intestinal obstruction. Intra-operatively findings showed loop of ileum entering through a defect in the right obturator canal. The obturator defect was closed by approximation flap of peritoneum and covered by right ovair and fallopian tube. Clinical discussion This case is reported because of its an uncommon type of abdominal wall hernia with high probability of bowel strangulation and highest morbidity and mortality rates. There are no international guidelines for treatment and the best surgical approach still unknown. Conclusion The diagnosis of OH should be suspected every time there is an intestinal obstruction of unknown origin in emaciated elderly women. Open or laparoscopic sutured repair surgery and placement of mesh remain the most common method of repair. Obturator Hernia is an uncommon type of abdominal wall hernia. It has the highest morbidity and mortality rates of all abdominal wall hernias. Emergency surgery is crucial for the treatment of strangulated obturator hernia. The ideal treatment and the best surgical approach still unknown.
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Affiliation(s)
- Mohamed Ben Khalifa
- General Surgery Department, Tahar sfar Hospital Mahdia, Faculty of Medicine, University of Monastir, Tunisia.
| | - Mohamed Maatouk
- A21 Surgery Department, Research Laboratory LR12ES01, Charles Nicolle Hospital, Faculty of Medicine of Tunis/Tunis El Manar University, Rue 9 avril - 1007 Bab Saadoun, Tunis, Tunisia
| | - Mossaab Ghannouchi
- General Surgery Department, Tahar sfar Hospital Mahdia, Faculty of Medicine, University of Monastir, Tunisia
| | - Seif Hammouda
- General Surgery Department, Tahar sfar Hospital Mahdia, Faculty of Medicine, University of Monastir, Tunisia
| | - Karim Nacef
- General Surgery Department, Tahar sfar Hospital Mahdia, Faculty of Medicine, University of Monastir, Tunisia
| | - Moez Boudokhane
- General Surgery Department, Tahar sfar Hospital Mahdia, Faculty of Medicine, University of Monastir, Tunisia
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13
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Delgado A, Bhuller SB, Phan P, Weaver J. Rare case of obturator hernia: Surgical anatomy, planning, and considerations. SAGE Open Med Case Rep 2022; 10:2050313X221081371. [PMID: 35341101 PMCID: PMC8943527 DOI: 10.1177/2050313x221081371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Abstract
Obturator hernia is a rare variation of abdominal hernias that cause significant
morbidity and mortality, especially in the elderly population. Incidence rates vary but
account for approximately 0.07%–1.0% of all hernias. Literature on laparoscopic versus
laparotomy, as well as types of closure (primary vs mesh) have not been well described in
the literature. Obturator hernias, although rare, require a high index of suspicion and
care in surgical management as many of these patients will be elderly with a multitude of
comorbid conditions. Further research and reporting on technique and type of closures
utilized when these rare hernias are encountered by surgeons would benefit the surgical
community on practices and management of obturator hernias. Here, we present a case of an
elderly female who presented with complaints of obstructive symptoms and abdominal pain
secondary to an obturator hernia.
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Affiliation(s)
- Adam Delgado
- Department of Surgery, Sky Ridge Medical Center, Lone Tree, CO, USA
| | - Sidra B Bhuller
- Department of Surgery, Sky Ridge Medical Center, Lone Tree, CO, USA
| | - Peter Phan
- Department of Surgery, Sky Ridge Medical Center, Lone Tree, CO, USA
| | - John Weaver
- Department of Surgery, Sky Ridge Medical Center, Lone Tree, CO, USA
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