Zhu Siqi, Zha Guosong, Gong Weiqiang, Cheng Chunfa
Department of Vascular and Hernia Surgery, The First People's Hospital of Linping District, No. 369, Yingbin Road, Nanyuan Street, Hangzhou, 311199, Zhejiang, China.
J Med Case Rep. 2025 Sep 25;19(1):443. doi: 10.1186/s13256-025-05521-7.
Obturator hernia is a rare type of abdominal wall hernia, predominantly seen in elderly women. It often presents with symptoms of intestinal obstruction, which require emergency medical attention. Computed tomography scanning is a crucial diagnostic tool for this condition.
This article reports the case of an 80-year-old Chinese female patient with a left-sided incarcerated obturator hernia complicated by ipsilateral intermuscular venous thrombosis in the lower limb. Emergency laparoscopic exploration revealed the simultaneous presence of an ipsilateral inguinal and femoral hernia, along with a contralateral obturator and femoral hernia. After balancing treatment urgency with systemic risk control, the patient underwent the laparoscopic transabdominal preperitoneal repair to address the left-sided incarcerated obturator hernia, femoral hernia, and inguinal hernia. Postoperatively, the patient recovered well, with significant relief of left leg pain and no progression of the thrombosis.
This case highlights the complexity of diagnosing and managing incarcerated obturator hernias. Successful management relies on vigilance for atypical symptoms, precise imaging evaluation, a multidisciplinary decision-making approach prioritizing emergencies and risk stratification, and the integration of minimally invasive techniques with damage control principles.
闭孔疝是一种罕见的腹壁疝类型，主要见于老年女性。它常表现为肠梗阻症状，需要紧急医疗处理。计算机断层扫描是诊断这种疾病的关键工具。
本文报道了一名80岁中国女性患者，患有左侧嵌顿性闭孔疝并伴有同侧下肢肌间静脉血栓形成。急诊腹腔镜探查发现同时存在同侧腹股沟疝和股疝，以及对侧闭孔疝和股疝。在平衡治疗紧迫性与全身风险控制后，患者接受了腹腔镜经腹腹膜前修补术，以处理左侧嵌顿性闭孔疝、股疝和腹股沟疝。术后，患者恢复良好，左腿疼痛明显缓解，血栓未进展。
该病例突出了诊断和处理嵌顿性闭孔疝的复杂性。成功的处理依赖于对非典型症状的警惕、精确的影像学评估、优先考虑紧急情况和风险分层的多学科决策方法，以及将微创技术与损伤控制原则相结合。
