Abstract
Purpose
Obturator hernia (OH) is a rare type of pelvic hernia. As the symptoms are nonspecific and the physical findings are obscure, a correct diagnosis is often delayed until laparotomy for bowel obstruction, despite advances in diagnostic modalities. The high postoperative mortality rate is often attributed to the delay in diagnosis. This article aimed to review the diagnosis and management of OH patients at our hospital, by describing the clinical presentation, diagnostic modalities, and management.
Methods
We reviewed ten patients who underwent surgery for an OH within a 5-year period, all of whom were elderly, thin, and parous women.
Results
A correct preoperative diagnosis based on computed tomography (CT) findings was made in all ten patients. All of the patients survived, but three suffered postoperative complications.
Conclusions
Based on our experience, when an elderly, thin, and parous woman presents with vomiting, abdominal or thigh pain, and intestinal obstruction, the differential diagnosis should include OH. Early diagnosis and prompt initiation of treatment reduces the risk of surgical complications and increases the chance of survival.
Similar content being viewed by others
References
Hsu CH, Wang CC, Jeng LB, Chen MF (1993) Obturator hernia: a report of eight cases. Am Surg 59:709–711
Gray SW, Skandalakis JE, Soria RE, Rowe JS Jr (1974) Strangulated obturator hernia. Surgery 75:20–27
Cubillo E (1983) Obturator hernia diagnosed by computed tomography. Am J Roentgenol 140:735–736
Yokoyama Y, Yamaguchi A, Isogai M, Hori A, Kaneoka Y (1999) Thirty-six cases of obturator hernia: does computed tomography contribute to postoperative outcome? World J Surg 23:214–217
Bjork KJ, Mucha P Jr, Cahill DR (1988) Obturator hernia. Surg Gynecol Obstet 167:217–222
Rogers FA (1964) Strangulated obturator hernia. In: Nyhus LM, Harkins JN (eds) Hernia. Lippincott, Philadelphia, pp 637–644
Yip AW, AhChong AK, Lam KH (1993) Obturator hernia: a continuing diagnostic challenge. Surgery 113:266–269
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
Ijiri R, Kanamaru H, Yokoyama H, Shirakawa M, Hashimoto H, Yoshino G (1996) Obturator hernia: the usefulness of computed tomography in diagnosis. Surgery 119:137–140
Zerbey AL 3rd, Larsen CR, Sanders LE (1993) Bilateral obturator hernias: case report, radiographic characteristics, and brief review of literature. Comput Med Imaging Graph 17:465–468
Bergstein JM, Condon RE (1996) Obturator hernia: current diagnosis and treatment. Surgery 119:133–136
Chung CC, Mok CO, Kwong KH, Ng EK, Lau WY, Li AK (1997) Obturator hernia revisited: a review of 12 cases in 7 years. J R Coll Surg Edinb 42:82–84
Nakayama T, Kobayashi S, Shiraishi K, Nishiumi T, Mori S, Isobe K, Furuta Y (2002) Diagnosis and treatment of obturator hernia. Keio J Med 51:129–132
Kammori M, Mafune K, Hirashima T, Kawahara M, Hashimoto M, Ogawa T, Ohta H, Hashimoto H, Kaminishi M (2004) Forty-three cases of obturator hernia. Am J Surg 187:549–552
Thanapaisan C, Thanapaisal C (2006) Sixty-one cases of obturator hernia in Chiangrai Regional Hospital: retrospective study. J Med Assoc Thai 89:2081–2085
Haraguchi M, Matsuo S, Kanetaka K, Tokai H, Azuma T, Yamaguchi S, Kanematsu T (2007) Obturator hernia in an ageing society. Ann Acad Med Singapore 36:413–415
Huszty G, Mogami K, Sawada T, Seki H, Sakusabe M, Ohuchi S, Kotanagi H (2007) Preoperative evaluation of irreversible bowel ischemia in obturator hernia. Hepatogastroenterology 54:775–779
Rodríguez-Hermosa JI, Codina-Cazador A, Maroto-Genover A, Puig-Alcántara J, Sirvent-Calvera JM, Garsot-Savall E, Roig-García J (2008) Obturator hernia: clinical analysis of 16 cases and algorithm for its diagnosis and treatment. Hernia 12:289–297
Sinha SN, DeCosta AE (1983) Obturator hernia. Aust N Z J Surg 53:349–351
Schmidt PH, Bull WJ, Jeffery KM, Martindale RG (2001) Typical versus atypical presentation of obturator hernia. Am Surg 67:191–195
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
Cueto-García J, Rodríguez-Diaz M, Elizalde-Di Martino A, Weber-Sanchez A (1998) Incarcerated obturator hernia successfully treated by laparoscopy. Surg Laparosc Endosc 8:71–73
Kim JJ, Jung H, Oh SJ, Lee KH, Park SM, Kim YH, Kim JG (2005) Laparoscopic transabdominal preperitoneal hernioplasty of bilateral obturator hernia. Surg Laparosc Endosc Percutan Tech 15:106–109
Haith LR Jr, Simeone MR, Reilly KJ, Patton ML, Moss BE, Shotwell BA (1998) Obturator hernia: laparoscopic diagnosis and repair. JSLS 2:191–193
Miki Y, Sumimura J, Hasegawa T, Mizutani S, Yoshioka Y, Sasaki T, Kamike W, Ito T, Monta O, Nagai I (1998) A new technique of laparoscopic obturator hernia repair: report of a case. Surg Today 28:652–656
Losanoff JE, Richman BW, Jones JW (2002) Obturator hernia. J Am Coll Surg 194:657–663
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Igari, K., Ochiai, T., Aihara, A. et al. Clinical presentation of obturator hernia and review of the literature. Hernia 14, 409–413 (2010). https://doi.org/10.1007/s10029-010-0658-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10029-010-0658-z