Obturator hernia - MRI image.

Obturator hernia although considered a rare entity is the most frequently encountered pelvic floor hernia. Since the first published report in the 18th century, their unusual and unfamiliar clinical presentation still represents a diagnostic dilemma for the modern day clinician. A detailed history and clinical examination in our thin, elderly female patient who presented with intermittent small bowel obstruction and symptoms of right obturator nerve compression with a positive Howship-Romberg sign was crucial in establishing a diagnosis. Sophisticated radiologic modalities such as MRI as shown below in the case of our patient can reliably confirm the diagnosis of obturator hernia.