Skip to main content

The obturator hernia: Difficult to diagnose, easy to repair

Hernia volume 8, pages 155–157 (2004)Cite this article

Abstract

Background

The aim of this paper is to present a simple method for obturator hernia repair in two cases with strangulated obturator hernia.

Methods

The authors report on two cases of mechanical bowel obstruction due to incarcerated obturator hernia in elderly, thin women. Both patients presented with clinical and radiological signs of small bowel obstruction. Neither of them had the Howship-Romberg or Hannington-Kiff sign.

Results

At laparotomy, incarcerated small bowel in a right-sided obturator hernia was observed in both patients. The small bowel was not necrotic, and no bowel resection was performed. The hernial defect was closed in two layers with interrupted and purse-string nonabsorbable sutures.

Conclusions

Obturator hernia is rare and difficult to diagnose. Often the diagnosis is reached only at laparotomy for small bowel obstruction. The double-layer repair with interrupted and purse-string nonabsorbable sutures could be useful, especially in emergency laparotomies for incarcerated obturator hernia.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1.

References

  1. Green BT (2001) Strangulated obturator hernia: still deadly. South Med J 94:81–83

    CAS  PubMed  Google Scholar 

  2. Schmidt PH, Bull WJ, Jeffery KM, Martindale RG (2001) Typical versus atypical presentation of obturator hernia. Am Surg 67:191–195

    CAS  PubMed  Google Scholar 

  3. Martinez Insua C, Costa Pereira JM, Cardoso de Oliveira M (2001) Obturator hernia: the plug technique. Hernia 5:161–163

    PubMed  Google Scholar 

  4. Lo CY, Lorentz TG, Lau PW (1994) Obturator hernia presenting as small bowel obstruction. Am J Surg 167:396–398

    CAS  PubMed  Google Scholar 

  5. Lobo DN, Clarke DJ, Barlow AP (1998) Obturator hernia: a new technique for repair. J R Coll Surg Edinb 43:33–34

    CAS  PubMed  Google Scholar 

  6. Haith LR Jr, Simeone MR, Reilly KJ, Patton ML, Moss BE, Shotwell BA (1998) Obturator hernia: laparoscopic diagnosis and repair. JSLS 2:191–193

    PubMed  Google Scholar 

  7. Bergstein JM, Condon RE (1996) Obturator hernia: current diagnosis and treatment. Surgery 119:133–136

    CAS  PubMed  Google Scholar 

  8. Steve E (1997) Hernias: obturator hernia. In: David CS et al. Sabiston textbook of surgery WB Saunders Company, US, pp 1230

  9. Hannington- Kiff JG (1980) Absent thigh reflex in obturator hernia. Lancet 1:180

    PubMed  Google Scholar 

  10. Nishina M, Fujii C, Ogino R, Kobayashi R, Kohama A (2001) Preoperative diagnosis of obturator hernia by computed tomography in six patients. J Emerg Med 20:277–280

    Article  CAS  PubMed  Google Scholar 

  11. Naude G, Bongard F (1997) Obturator hernia is an unsuspected diagnosis. Am J Surg 174:72–75

    Article  CAS  PubMed  Google Scholar 

  12. Yokoyama T, Munakata Y, Ogiwara M, Kamijima T, Kitamura H, Kawasaki S (1997) Preoperative diagnosis of strangulated obturator hernia using ultrasonography. Am J Surg 174:76–78

    Article  CAS  PubMed  Google Scholar 

  13. Skandalakis LJ, Skandalakis PN, Colborn PN, Skandalakis JE (2000) Obturator hernia embryology, anatomy, surgery. Hernia 4:121–128

    Google Scholar 

  14. Marchal F, Parent S, Tortuyaux JM, Bresler L, Boissel P, Regent D (1997) Obturator hernias. Report of seven cases. Hernia 1:23–26

    Google Scholar 

  15. Cresienzo D, Faranda C, Perrot L, Champault G (1998) Laparoscopic treatment of a strangulated obturator hernia. Hernia 2:203–205

    Google Scholar 

  16. De Leo S, Gullà N, Patriti A, Bufalari A, Capitanucci L, Ciaccio V, Tristaino B (2000) Obturator hernia: a new device in mesh repair. Hernia 4:155–158

    Google Scholar 

  17. Maharaj D, Maharaj S, Young L, Ramdass MJ, Naraynsingh V (2002) Obturator hernia repair: A new technique. Hernia 6:45–47

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. A. P. Uchikov

    Present address: Department of Surgery Division of Thoraco-abdominal Surgery, Higher Medical Institute Plovdiv Hirurgicheski kliniki, Blvd. Peshtersko shosse no. 16, 4002, Plovdiv, , Bulgaria

Affiliations

  1. Department of Surgery, Medical University, Plovdiv, Bulgaria

    C. D. Shipkov, A. P. Uchikov & E. Grigoriadis

Authors
  1. C. D. Shipkov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. P. Uchikov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Grigoriadis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. P. Uchikov.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Shipkov, C.D., Uchikov, A.P. & Grigoriadis, E. The obturator hernia: Difficult to diagnose, easy to repair. Hernia 8, 155–157 (2004). https://doi.org/10.1007/s10029-003-0177-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-003-0177-2

Keywords

  • Small bowel obstruction
  • Obturator hernia
  • Hernial defect