RT Journal Article SR Electronic T1 Obturator hernia of Richter type: a diagnostic dilemma JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e238252 DO 10.1136/bcr-2020-238252 VO 13 IS 12 A1 Cathal Hayes A1 Karl Schmidt A1 Yuwaraja Neduchelyn A1 Ivan Ivanovski YR 2020 UL http://casereports.bmj.com/content/13/12/e238252.abstract AB An 85-year-old malnourished woman presented with symptoms of small bowel obstruction of uncertain aetiology. She had presented numerous times over the previous 2 years with symptoms of left groin and thigh pain, vomiting and abdominal distension. A CT of her abdomen and pelvis ultimately revealed a left-sided pelvic hernia, between the obturator internus and pectineal muscles. This was consistent with an obturator hernia. Diagnostic laparoscopy confirmed an obturator hernia of Richter type, incarcerated within the left obturator canal. Reduction revealed a hernia sac containing viable small bowel. A primary repair was performed using a double-layer suture technique to both close and plug the hernia defect. The patient rapidly recovered following hernia repair, with resolution of all previous long-standing symptoms. This case exemplifies the typical presentation of an obturator hernia and the diagnostic challenge it poses to clinicians.