Strangulated obturator hernia.
نویسندگان
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
منابع مشابه
A Masquerading and Unconventional Cause of Dynamic Intestinal Obstruction: Strangulated Obturator Hernia
Obturator hernia is an extremely rare type of abdominal wall hernia occurring mostly in elderly, thin females. It is characterized by the herniation of intra-abdominal contents through the obturator foramen. Symptoms are often nonspecific, and the patient usually presents with an acute or subacute intestinal obstruction. A high index of suspicion is needed in such females presenting with abdomi...
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Obturator hernia is a rare condition that may present in an acute or subacute setting in correlation with the degree of small-bowel obstruction. Pre-operative diagnosis is difficult, as symptoms are often non-specific. A high index of suspicion should be maintained for emaciated elderly women with small-bowel obstruction without a previous abdominal operation and a positive Howship-Romberg sign...
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ورودعنوان ژورنال:
- BMJ case reports
دوره 2014 شماره
صفحات -
تاریخ انتشار 2014