Abstract
Purpose
It is generally believed that sciatic hernia is extremely rare; however, asymptomatic sciatic hernia is occasionally found in patients with an obturator hernia. We investigated the frequency, risk factors, and prognosis of asymptomatic sciatic hernia, which have never been discussed in a published report.
Methods
We retrospectively reviewed multidetector-row computed tomography (MDCT) images of 38 consecutive cases of new-onset obturator hernia. The co-existence of sciatic hernia was diagnosed from the MDCT findings of some of these patients. The clinical characteristics and clinical courses were compared between the sciatic hernia group and the non-sciatic hernia group.
Results
Nine patients (24 %) had concomitant asymptomatic sciatic hernias, five (13 %) of which were bilateral. The body mass index (BMI) was significantly lower in the patients with a concomitant sciatic hernia (17.2 ± 2.4 kg/m2) than in those without a sciatic hernia (19.6 ± 2.6 kg/m2; P = 0.02). All patients received treatment for incarcerated obturator hernias, but none underwent repair of the concomitant sciatic hernia because all were non-incarcerated and asymptomatic. None of the patients has had trouble with their untreated sciatic hernia after the obturator hernia treatment.
Conclusions
Up to 24 % of these obturator hernia patients had a concomitant sciatic hernia. A low BMI was a risk factor for concomitant sciatic hernia. Immediate surgical repair of the sciatic hernia may not be needed, unless it is symptomatic.
Similar content being viewed by others
References
Bernard AC, Lee C, Hoskins J, Lee J, Patel S, Ginn G, Maley B. Sciatic hernia: laparoscopic transabdominal extraperitoneal repair with plug and patch. Hernia. 2010;14:97–100.
Cali RL, Pitsch RM, Blatchford GJ, Thorson A, Christensen MA. Rare pelvic floor hernias. Report of a case and review of the literature. Dis Colon Rectum. 1992;35:604–12.
Hayashi N, Suwa T, Kimura F, Okuno A, Ishizuka M, Kakizaki S, Kawakami H. Radiographic diagnosis and surgical repair of a sciatic hernia: report of a case. Surg Today. 1995;25:1066–8.
Miklos JR, O’Reilly MJ, Saye WB. Sciatic hernia as a cause of chronic pelvic pain in women. Obstet Gynecol. 1998;91:998–1001.
Lo CY, Lorentz TG, Lau PW. Obturator hernia presenting as small bowel obstruction. Am J Surg. 1994;167:396–8.
Nasir BS, Zendejas B, Ali SM, Groenewald CB, Heller SF, Farley DR. Obturator hernia: the Mayo Clinic experience. Hernia. 2012;16:315–9.
Bjork KJ, Mucha P Jr, Cahill DR. Obturator hernia. Surg Gynecol Obstet. 1988;167:217–22.
Larrieu AJ, DeMarco SJ 3rd. Obturator hernia: report of a case and brief review of its status. Am Surg. 1976;42:273–7.
Conflict of interest
Takahiro Karasaki and his co-authors have no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Karasaki, T., Nakagawa, T. & Tanaka, N. Sciatic hernia: is it really rare?. Surg Today 44, 1079–1083 (2014). https://doi.org/10.1007/s00595-013-0742-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-013-0742-y