Leitch Megan Kathleen, Yunaev Michael
Department of Surgical, Royal Perth Hospital, Perth, Western Australia, Australia.
Saint Luke's Care, Potts Point, New South Wales, Australia.
BMJ Case Rep. 2016 Jun 29;2016:bcr2016215428. doi: 10.1136/bcr-2016-215428.
The obturator hernia is a rare type of hernia that can present a diagnostic challenge for the clinician. We report a case of an 88-year-old woman who presented with a history of right iliac fossa pain, bilious vomiting and diarrhoea. Non-specific findings on examination and blood tests made the diagnosis difficult, however, a CT scan of her abdomen revealed the site of the obstruction and the patient was taken to theatre for emergency surgery. We review the literature with focus on the diagnosis of obturator hernias and the different surgical approaches used. The authors believe that this case is of educational value to healthcare professionals, particularly those working in general practice, emergency departments and on surgical teams. It highlights to doctors that patients with incarcerated obturator hernias can present with or without overt signs of intestinal obstruction and emphasises the fact that an obturator hernia can be an important cause of intestinal obstruction in a thin, elderly woman.
闭孔疝是一种罕见的疝，可能给临床医生带来诊断挑战。我们报告一例88岁女性病例，该患者有右下腹疼痛、胆汁性呕吐和腹泻病史。体格检查和血液检查的非特异性结果使诊断困难，然而，腹部CT扫描显示了梗阻部位，患者被送往手术室进行急诊手术。我们回顾文献，重点关注闭孔疝的诊断及所采用的不同手术方法。作者认为该病例对医疗专业人员具有教育价值，尤其是那些从事全科医疗、急诊科和外科团队工作的人员。它向医生强调，嵌顿性闭孔疝患者可能有或没有明显的肠梗阻体征，并强调闭孔疝可能是瘦弱老年女性肠梗阻的重要原因。
