Intestinal obstruction caused by obturator hernia: Case series
Juan Francicsco Allamand Turner
Published 2019-03-04
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Abstract
Objective: 3 cases of intestinal obstruction that resulted in diagnosis of obturator hernia, their management and a brief international literature review are presented.
Material and methods: Discussion of the presentation, images, and management. In all cases surgery was performed the same day from the diagnosis of intestinal obstruction and confirmation of obturator hernia. The management of the hernia and it’s content was adjusted to each patient’s situation. Case 1: 80 year old woman presents with intestinal obstruction and palpable mass in right inguinal region. Images are informed as a femoral hernia and surgery is performed. An obturator hernia is found, unviable intestine is resected and defect repair is made with polipropileno mesh plug. Case 2: 91 year old woman arrives because of abdominal pain and vomits in the last 3 days. Images suggest intestinal obstruction but can not identify a cause. Laparotomy is performed and an obturator hernia is found. Resection of necrotic intestine is made and the defect is repaired with simple suture. Case 3: 78 year old woman with pain in the thigh that radiates to the abdomen. Imagenology informs a femoral hernia. Surgery is performed through preperitoneal approach. An obturator hernia is found and reduced. Repair of the defect is made with polipropileno mesh plug. Results: Our 3 patients, when reviewed retrospectively, had the classic presentations and images of obturator hernia. All of them had a favourable evolution with an early discharge and no complications on follow up.
Discussion: Our 3 cases had clinical presentations and imaging studies that correlated well with international literature.
Conclusion: Obturator hernia is an infrequent pathology, but appears in a particular type of patient and with classic presentation. Axial computed tomography is an important tool and usually makes the diagnosis previously to surgical exploration. It is important to consider this diagnosis when being faced with patients with intestinal obstruction.