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Obturator hernia (the little old lady’s hernia) diagnosed via computed tomography: a case report

Authors
  • Bohara, Sujan1
  • Karki, Samikshya2
  • Gautam, Anu3
  • Regmi, Binit U.4
  • Rimal, Sabin5
  • Khadka, Laxman6
  • Pokharel, Anuj3
  • Gurung, Bibek7
  • Rawal, Sushil B.1
  • 1 General and Gastrointestinal Surgery
  • 2 Spinal Injury Rehabilitation Center, Kavre, Nepal
  • 3 Nepalese Army Institute of Health Sciences, Kathmandu
  • 4 Jibjibe Primary Health Care Center, Rasuwa
  • 5 Chitwan Medical College, Bharatpur
  • 6 Patan Academy of Health Science, Patan
  • 7 Radiology, Nepal Mediciti Hospital, Lalitpur
Type
Published Article
Journal
Annals of Medicine and Surgery
Publisher
Elsevier BV
Publication Date
Apr 10, 2023
Volume
85
Issue
4
Pages
1282–1285
Identifiers
DOI: 10.1097/MS9.0000000000000578
PMID: 37113834
PMCID: PMC10129172
Source
PubMed Central
Keywords
Disciplines
  • Case Reports
License
Unknown

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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