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Rare disease
Case report
Diagnostic difficulties in obturator hernia: a rare case presentation and review of literature
  1. Tharun Ganapathy Chitrambalam,
  2. Pradeep Joshua Christopher,
  3. Jeyakumar Sundaraj and
  4. Sundeep Selvamuthukumaran
  1. General Surgery, SRM Institute of Science and Technology, Kattankulathur, India
  1. Correspondence to Dr Tharun Ganapathy Chitrambalam; tharungc{at}srmist.edu.in

Abstract

Hernia arising from obturator canal is rare and it contributes to about less than 1% of incidence of all hernias. Diagnosing an obturator hernia clinically is a challenging one and nearly impossible. These hernias usually present as an intestinal obstruction as more than 50% of obturator hernias goes in for strangulation. Here, we report an unusual presentation of an obturator hernia in a 70-year-old woman who presented to emergency room with acute abdomen and uncomplicated reducible inguinal hernia. Radiological imaging showed obstructed inguinal hernia while on diagnostic laparoscopy, a strangulated and perforated obturator hernia of Richter’s type was seen in addition to an uncomplicated inguinal hernia. Obturator hernia, although very rare, is associated with high morbidity and mortality as it is often underdiagnosed as in our case. Laparoscopy bailed us out from missing out a perforation from an occult obturator hernia.

  • ultrasonography
  • general surgery
  • gastrointestinal surgery
  • groin pain
  • small intestine
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bcr-2020-235644

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    Footnotes

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    • Contributors TGC is the major contributor of this study. Study design, data analysis, interpretation, drafting, critical revision and final approval of the article were done by him and he is completely accountable for the research work. PJC, Dr Jeyakumar Sundaraj and SS have helped in planning and reporting, extending administrative support, technical writing and proofreading.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.