Experience in diagnosis and treatment of obturator hernia: a report of 9 cases

doi:10.3877/cma.j.issn.1674-392X.2018.06.005

Abstract

Abstract:

Background

Obturator hernia is a rare abdominal external hernia. It is not well understood in clinic and may lead to delayed treatment due to misdiagnosis.

Objective

To summarize and discuss the etiology, diagnosis, treatment and prognosis of obturator hernia.

Methods

MSCT was performed in 8 cases, 7 cases showed obturator hernia with intestinal incarceration. 8 patients received emergency surgical treatment, and 1 patient received surgical treatment after 3 days of conservative treatment. Among them, 5 cases through conventional laparotomy and 4 cases through extraperitoneal approach via inguinal incision. 1 case underwent direct suture repair while 8 cases underwent mesh repair. 4 cases were implanted with biological mesh and 4 cases were implanted with synthetic mesh. After operation, 8 patients were cured and 1 died of septic shock. No recurrence occurred during the follow-up period.

Conclusion

Those elderly female patients with thin body and have multiple pregnancies history, when they appear unknown intestinal obstruction, should be considered the possibility diagnosis of obturator hernia and given proper treatments. MSCT can be taken as the golden criterion to diagnose obturator hernia. Once the diagnosis is confirmed, the surgeons should perform operations as soon as possible and pay attention to exploring the occult hernia. If there is no contraindication, using mesh repair is the most appropriate way to prevent recurrence.

Key words: Obturator hernia, CT examination, Surgical management, Patch repair

Yunxiao Meng, Ge Chen, Shaojie Li, Xingchen Hu, Lei Huang, Zhao Cai, Jianxiong Tang. Experience in diagnosis and treatment of obturator hernia: a report of 9 cases[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2018, 12(06): 418-421.

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