An extraordinary cause of intestinal obstruction, incarcerated obturator hernia

Abstract

AIM: Presenting an extraordinary cause of intestinal obtuction, leading to incarcerated obturator hernia.

CASE REPORT: We present a rare case of obturator hernia in a 90-year-old female, who presented with a three-day history of inability to defecate and abdominal pain, distension, and vomiting on the day of presentation. Hours later, a computed tomography scan revealed a bowel obstruction secondary to a right-sided obturator hernia. She underwent an emergency exploratory laparotomy and the incarcerated bowel was reduced with a repairment of the hernial defect. The patient demonstrated an uneventful postoperative period and was discharged on hospital day four.

DISCUSSION: Obturator hernia, a rare anterior abdominal wall hernia, in which abdominal contents protrude through the obturator canal, is an unusual cause of intestinal obstruction. It has one of the highest mortality rates of all abdominal wall hernias with a challenging diagnosis that can still be misleading even to the most experienced surgeons.

CONCLUSION: Providers should be aware of inability to defecate, abdominal pain, distension, and vomiting that may be due to an existence of incarcerated/strangulated obturator hernia, thus the further evaluation should be considered as the elements of the clinical picture are incongruent