K Igari1, T Ochiai, A Aihara, Y Kumagai, M Iida, S Yamazaki. 1. Department of Surgery, Ohta Nishinouchi General Hospital, 2-5-20, Nishinouchi, Koriyama, Fukushima 963-8558, Japan. gally@ohta-hp.or.jp
Abstract
PURPOSE: Obturator hernia (OH) is a rare type of pelvic hernia. As the symptoms are nonspecific and the physical findings are obscure, a correct diagnosis is often delayed until laparotomy for bowel obstruction, despite advances in diagnostic modalities. The high postoperative mortality rate is often attributed to the delay in diagnosis. This article aimed to review the diagnosis and management of OH patients at our hospital, by describing the clinical presentation, diagnostic modalities, and management. METHODS: We reviewed ten patients who underwent surgery for an OH within a 5-year period, all of whom were elderly, thin, and parous women. RESULTS: A correct preoperative diagnosis based on computed tomography (CT) findings was made in all ten patients. All of the patients survived, but three suffered postoperative complications. CONCLUSIONS: Based on our experience, when an elderly, thin, and parous woman presents with vomiting, abdominal or thigh pain, and intestinal obstruction, the differential diagnosis should include OH. Early diagnosis and prompt initiation of treatment reduces the risk of surgical complications and increases the chance of survival.
PURPOSE:Obturator hernia (OH) is a rare type of pelvic hernia. As the symptoms are nonspecific and the physical findings are obscure, a correct diagnosis is often delayed until laparotomy for bowel obstruction, despite advances in diagnostic modalities. The high postoperative mortality rate is often attributed to the delay in diagnosis. This article aimed to review the diagnosis and management of OH patients at our hospital, by describing the clinical presentation, diagnostic modalities, and management. METHODS: We reviewed ten patients who underwent surgery for an OH within a 5-year period, all of whom were elderly, thin, and parous women. RESULTS: A correct preoperative diagnosis based on computed tomography (CT) findings was made in all ten patients. All of the patients survived, but three suffered postoperative complications. CONCLUSIONS: Based on our experience, when an elderly, thin, and parous woman presents with vomiting, abdominal or thigh pain, and intestinal obstruction, the differential diagnosis should include OH. Early diagnosis and prompt initiation of treatment reduces the risk of surgical complications and increases the chance of survival.