Coexisting ipsilateral right femoral hernia and incarcerated obturator hernia.

Abstract

Obturator hernia (OH) is an uncommon cause of bowel obstruction and described in elderly females in the literature. The treatment has traditionally been laparotomy because of an acute nature of the condition. However, because of old age and comorbidities that OH is associated with, general anaesthesia may need to be avoided. In the current case, a transinguinal preperitoneal approach and management are presented after delayed preoperative diagnosis of bowel obstruction caused by a coexisting right incarcerated OH and ipsilateral non-reducible femoral hernia. A 91-year-old woman had a 6-day history of nausea and vomiting. She was referred to surgery because of persisting vomiting, but without any abdominal pain. A CT scan showed a hernia in the right groin area but the diagnosis was delayed. The hernias were repaired using a preperitoneal transinguinal approach. Bowel resection was not needed. The obturator canal and the femoral ring were both covered by a Bard Polysoft patch.

• Authors: Toni T Seppälä, Mikko Tuuliranta
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Feb 25 2015) ISSN: 1757-790X [Electronic] England
• PMID: 25716157 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Topics

• Aged, 80 and over
• Female
• Hernia, Femoral (complications, diagnosis, surgery)
• Hernia, Obturator (complications, diagnosis, surgery)
• Herniorrhaphy (methods)
• Humans
• Intestinal Obstruction (diagnosis, etiology, surgery)
• Laparotomy (methods)
• Nausea (etiology)
• Surgical Mesh
• Tomography, X-Ray Computed
• Treatment Outcome
• Vomiting (etiology)