Obturator hernia is a rare type of
hernia which accounts for only 0.07-1.4% of all
intra-abdominal hernias and 0.2-5.8% of small-
intestinal obstructions. It develops predominantly in elderly underweight women. It has nonspecific early symptoms, so these
hernias are usually discovered only after they have become incarcerated. Incarcerated
obturator hernias are usually discovered on abdominal computed tomography scan or emergency surgery due to bowel obstruction. Here we present a case of a 65-year-old female who presented with intermittent
abdominal pain, distension and
nausea for last 3 days. She was a known case of
hypothyroidism, taking
Levothyroxine in inadequate dose. Her intial abdominal Xray was showing few air-fluid level with air present in rectum. She was initially managed conservatively but later developed features of
peritonitis for which she was operated. In
laparotomy, Richter type of right-sided incarcerated
obturator hernia was discovered with a small necrotic area and perforation of small bowel. Bowel resection was performed and
obturator hernia was closed with interrupted
sutures. The patient recovered without complications.
Obturator hernia, due to its rarity and nonspecific early symptoms, can still be misleading even to the most experienced clinicians. Delay in diagnosis of
obturator hernia can lead to bowel
necrosis and perforation with significant postoperative morbidity and mortality.