Strangulated obturator hernia.

نویسندگان

  • Rahul Gupta
  • Harjeet Singh
  • Mandeep Kang
  • Rajinder Singh
چکیده

To cite: Gupta R, Singh H, Kang M, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014207071 DESCRIPTION A frail 60-year-old woman presented with a 5-day history of pain in the abdomen, constipation, vomiting and abdominal distension. There was no history of surgery or tuberculosis. On examination, the abdomen was distended and non-tender. The hernial sites were normal. On auscultation, hyperperistaltic bowel sounds were present. On X-ray of the abdomen there were multiple air fluid levels. Contrast-enhanced CT of the abdomen and pelvis showed right-sided obturator hernia (arrow) containing ischaemic small bowel loops with intestinal obstruction (figure 1). At emergency laparotomy, the terminal ileum was found to be entering the right obturator foramen with gross dilation of proximal bowel loops (figure 2). On reduction of the hernia, the herniated bowel loop was found to be gangrenous; it was resected and primary anastomosis was performed. The hernial sac was also identified in the obturator region on the contralateral side (figure 3). Obturator hernia is a rare type of abdominal wall hernia accounting for 0.05–0.4% of all cases. It is seen most commonly in frail, elderly multiparous females. Most cases present with acute intestinal obstruction and are diagnosed intraoperatively. The classical ‘Howship-Romberg’ and ‘Hannington-Kiff ’ signs of obturator hernia are uncommon and often

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عنوان ژورنال:
  • BMJ case reports

دوره 2014  شماره 

صفحات  -

تاریخ انتشار 2014