Obturator hernia presenting as small bowel obstruction.

Published on Apr 1, 1994in American Journal of Surgery2.565
路 DOI :10.1016/0002-9610(94)90123-6
Chung-Yau Lo73
Estimated H-index: 73
,
Theo G. Lorentz6
Estimated H-index: 6
,
Peter W. K. Lau8
Estimated H-index: 8
Sources
Abstract
Abstract Obturator hernia is a rare but important cause of small bowel obstruction that is associated with difficult diagnosis and high mortality. In the past 7 years, 16 patients with small bowel obstruction due to obturator hernia diagnosed at operation were seen at the Department of Surgery, the University of Hong Kong, Queen Mary Hospital. They represented 1% (16 of 1,554) of all hernia repair performed and 1.6% (16 of 1,000) of mechanical intestinal obstruction encountered during the same period. Elderly emaciated women with chronic disease were commonly affected. All patients presented with partial or complete mechanical small bowel obstruction. Right-sided obturator hernia outnumbered left-sided hernia, and bilateral hernia was found in only one patient. The majority of patients required resection of their strangulated small bowel. Most of the hernial orifices were closed with interrupted nonabsorbable sutures. Morbidity and mortality rates were significantly high for this group of debilitated patients with chronic disease who underwent late operation for this elusive diagnosis.
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: Obturator hernia is a rare condition which was first described in 1722 by de Ronsil. It occurs most commonly in elderly women who have lost weight and may strangulate in 25-100% of cases. Strangulated obturator hernia has a mortality as high as 10-50%, which is partly due to delay in diagnosis. A patient who developed three obturator hernias is described.
3 observations, dont 2 ou une nouvelle methode est utilisee pour l'operation: couverture de l'orifice par la paroi de la vessie
The diagnosis of obturator hernia is clinically difficult in the absence of signs related to the compression of the obturator nerve (Howship-Romberg sign). A specific diagnosis of obturator hernia can be made if computed tomography (CT) of the pelvis is performed when the diagnosis is likely, such as in elderly, debilitated women with small bowel obstruction without a clear cause.
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#2George D. ZuidemaH-Index: 1
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#1James M. KozlowskiH-Index: 40
#2John M. Beal (NU: Northwestern University)H-Index: 3
鈥 Obturator hernia is an uncommon problem that occurs predominantly in elderly, debilitated women. The diagnosis should be suspected in such patients who have evidence of small bowel obstruction, often initially intermittent, and who complain of pain along the anteromedial aspect of the thigh. We present experience with three patients that characterizes the difficulties in diagnosis and treatment. Most patients require resection of the incarcerated bowel. Mortality is variable and is related to ...
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#1Gray SwH-Index: 20
#2John E. SkandalakisH-Index: 31
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#1Jing ZhangH-Index: 1
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To detect risk factors on clinical characteristics and multidetector聽computed tomographic (MDCT) findings for predicting bowel obstruction in patients with obturator hernia. We retrospectively reviewed 47 patients who had an obturator hernia diagnosed by MDCT and/or surgery. The patients were divided into obstruction and non-obstruction group based on the presence or absence of bowel obstruction on MDCT images. Uni- and multivariate analyses were performed to identify risk factors for predicting...
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#1Mikkel Andreas Holm (UCPH: University of Copenhagen)
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BACKGROUND Obturator hernias are rare and associated with high mortality. However, the optimal surgical approach remains unknown. We aimed to investigate the available evidence and examine the surgical details regarding obturator hernia defect closure as well as the recurrence rates of the different approaches. METHODS We reported this scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analysis Extension for Scoping Reviews) and registered the p...
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BACKGROUND Obturator hernia is rare and accounts for less than 1% of all abdominal wall hernias. It represents a diagnostic challenge due to its nonspecific signs and symptoms. CASE PRESENTATION We present a case of an 89-year-old caucasian female with a 12-hour history of right medial thigh pain. Computed tomography scan revealed a right obturator hernia with small bowel obstruction. The hernia was successfully repaired laparoscopically without any need for small bowel resection. She was discha...
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PURPOSE Obturator hernias (OH) are extremely rare hernias, accounting for 0.07-1% of all hernias. This is the first systematic review investigating their presentation, imaging, treatment outcomes, and recurrence rate. METHODS After a detailed search in electronic search engines, 74 studies matched our criteria. A review of these reports was conducted and the full texts were examined. RESULTS A total of 146 patients with a mean age of 78.8聽years were included in our analysis, with 40.1%, 29.9%, a...
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Obturator hernia is a rare condition, characterized by the herniation of an intestinal segment between the obturator and the pectineus muscles through the obturator foramen. Obturator hernias usually occur in the elderly and are less common in males than in females, with a male-to-female ratio of about 1/14. In recent years, the use of diagnostic imaging, especially CT, to determine the causes of intestinal obstruction has been improved to allow for an early and accurate diagnosis, even of obtur...
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#1Fidel Rampersad (UWI: University of the West Indies)H-Index: 5
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An 89-year-old multiparous woman presented to the emergency department with a 1-week history of multiple episodes of bilious vomiting, abdominal distention and lower abdominal pain- radiating to the right thigh. She had no history of abdominal surgery, however her comorbidities included diabetes
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: Obturator hernia is an extremely rare condition accounting for almost 0.07%-1% of all abdominal wall hernias, usually occurring in the elderly and emaciated females with a history of previous abdominal surgery. The symptoms of this particular hernia are non-specific; therefore, a high index of clinical suspicion should always be made. This rare condition may lead to acute small intestinal obstruction. The pre-operative diagnosis is challenging and often misleading on occasions, especially in c...
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We report a case of a 90-year-old female with intestinal obstruction due to left-sided incarcerated obturator hernia, which was revealed using computed tomography. Emergency surgery was performed u...
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