Kulkarni Sanjeev R, Punamiya Aditya R, Naniwadekar Ramchandra G, Janugade Hemant B, Chotai Tejas D, Vimal Singh T, Natchair Arafath
Department of Surgery, Krishna Institute of Medical Sciences University, Karad 415110, Maharashtra, India.
Int J Surg Case Rep. 2013;4(7):606-8. doi: 10.1016/j.ijscr.2013.02.023. Epub 2013 Apr 17.
Obturator hernia is an extremely rare type of hernia with relatively high mortality and morbidity. Its early diagnosis is challenging since the signs and symptoms are non specific.
Here in we present a case of 70 years old women who presented with complaints of intermittent colicky abdominal pain and vomiting. Plain radiograph of abdomen showed acute dilatation of stomach. Ultrasonography showed small bowel obstruction at the mid ileal level with evidence of coiled loops of ileum in pelvis. On exploration, Right Obstructed Obturator hernia was found. The obstructed Intestine was reduced and resected and the obturator foramen was closed with simple sutures. Postoperative period was uneventful.
Obturator hernia is a rare pelvic hernia and poses a diagnostic challenge. Obturator hernia occurs when there is protrusion of intra-abdominal contents through the obturator foramen in the pelvis. The signs and symptoms are non specific and generally the diagnosis is made during exploration for the intestinal obstruction, one of the four cardinal features. Others are pain on the medial aspect of thigh called as Howship Rombergs sign, repeated attacks of Intestinal Obstruction and palpable mass on the medial aspect of thigh.
Obturator hernia is a rare but significant cause of intestinal obstruction especially in emaciated elderly woman and a diagnostic challenge for the Doctors. CT scan is valuable to establish preoperative diagnosis. Surgery either open or laproscopic, is the only treatment. The need for the awareness is stressed and CT scan can be helpful.
闭孔疝是一种极为罕见的疝，其死亡率和发病率相对较高。由于其体征和症状不具有特异性，早期诊断具有挑战性。
在此我们呈现一例70岁女性患者，她主诉间歇性绞痛性腹痛和呕吐。腹部平片显示胃急性扩张。超声检查显示回肠中段水平小肠梗阻，盆腔内有回肠盘绕袢的迹象。经探查，发现右侧闭孔疝伴梗阻。梗阻肠段复位并切除，闭孔管用简单缝线缝合。术后恢复顺利。
闭孔疝是一种罕见的盆腔疝，构成诊断挑战。当腹腔内容物通过盆腔内的闭孔突出时，就会发生闭孔疝。其体征和症状不具有特异性，通常在因肠梗阻进行探查时作出诊断，肠梗阻是其四大主要特征之一。其他特征包括大腿内侧疼痛（称为豪希普·龙伯格征）、反复肠梗阻发作以及大腿内侧可触及肿块。
闭孔疝是肠梗阻的一种罕见但重要的病因，尤其是在消瘦的老年女性中，对医生来说是一个诊断挑战。CT扫描对术前诊断有价值。开放手术或腹腔镜手术是唯一的治疗方法。强调提高认识的必要性，CT扫描可能会有所帮助。
