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CLINICAL IMAGE
Year : 2014  |  Volume : 140  |  Issue : 1  |  Page : 151

Obturator hernia: a rare cause of acute small bowel obstruction


Division of Hematology-Oncology Department of Internal Medicine Tri-service General Hospital National Defense Medical Center Taipei, Taiwan

Date of Web Publication4-Sep-2014

Correspondence Address:
Tzu-Chuan Huang
Division of Hematology-Oncology Department of Internal Medicine Tri-service General Hospital National Defense Medical Center Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None


PMID: 25222793

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How to cite this article:
Lai SW, Huang TC. Obturator hernia: a rare cause of acute small bowel obstruction . Indian J Med Res 2014;140:151

How to cite this URL:
Lai SW, Huang TC. Obturator hernia: a rare cause of acute small bowel obstruction . Indian J Med Res [serial online] 2014 [cited 2019 Nov 20];140:151. Available from: http://www.ijmr.org.in/text.asp?2014/140/1/151/140107

An 89-yr old woman presented to the emergency department, Tri-Service General Hospital, Taiwan, with diffuse abdominal pain for one day in April 2012. Her abdomen was distended, hypoactive and tender without palpable masses. Abdominal plain radiograph showed intestinal obstruction [Figure 1]. The computed tomography (CT) of abdomen demonstrated incarceration of the small bowel into the left obturator foramen [Figure 2]. An obturator hernia with intestinal obstruction was diagnosed. She underwent emergency laparotomy combined with hernia repair and resection of the affected bowel. She exhibited no symptoms two months after discharge.
Figure 1: Plain abdominal radiograph showing segmental dilated loops of the small intestine in middle and lower abdomen (red block arrow).

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Figure 2: The axial CT scan of abdomen showing incarcerated bowel loop protruding into the left obturator foramen (a, b, red block arrow). The longitudinal CT image of abdomen demonstrated a small bowel loop between the left obturator externus and pectineus muscles and diffused dilatation of small bowel loops (c, red block arrow).

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An obturator hernia is an infrequent but significant cause of bowel gangrene, especially on the left, accounting for 1.6 per cent of intestinal obstructions [1] .

It is difficult to diagnose early because of initial non specific presentations. Prompt abdominal CT scan may reveal herniated loops of small bowel protruding the obturator foramen and lying between the pectineus and obturator muscles [2] .

Appropriate image studies and immediate surgical intervention can prevent possible bowel ischaemia and improve clinical outcomes [3] .



 
   References Top

1.Petrie A, Tubbs RS, Matusz P, Shaffer K, Loukas M. Obturator hernia: anatomy, embryology, diagnosis, and treatment. Clin Anat 2011; 24 : 562-9.  Back to cited text no. 1
    
2.Meziane MA, Fishman EK, Siegelman SS. Computed tomographic diagnosis of obturator foramen hernia. Gastrointest Radiol 1983; 8 : 375-7.  Back to cited text no. 2
[PUBMED]    
3.Mandarry MT, Zeng SB, Wei ZQ, Zhang C, Wang ZW. Obturator hernia--a condition seldom thought of and hence seldom sought. Int J Colorectal Dis 2012; 27 : 133-41.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2]



 

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