Obturator hernia is a rare type of
abdominal hernia where herniation occurs through the obturator canal. It develops predominantly in elderly underweight women. It has unspecific early symptoms, which is the reason these
hernias are usually discovered only after they have become incarcerated. Incarcerated
obturator hernias are usually discovered on abdominal computed tomography (CT) scan or emergency surgery due to bowel obstruction. We present a case of an 85-year-old female patient who was admitted because of intermittent
abdominal pain and
vomiting. Consecutive upright abdominal x-rays failed to show bowel obstruction. Abdominal CT scan revealed a right-sided incarcerated
femoral hernia that was not found during emergency surgery. After
laparotomy had been performed, a Richter type of right-sided incarcerated
obturator hernia was discovered with a small necrotic area on the 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 unspecific early symptoms, can still be misleading even to the most experienced surgeons. Delayed diagnosis of
obturator hernia can lead to bowel
necrosis and perforation with significant postoperative morbidity and mortality.