ABSTRACT
Introduction: Obturator hernia is an important cause of small bowel obstruction and is associated with difficult diagnosis and high mortality. Materials and Methods: We reviewed 22 cases of intestinal obstruction due to obturator hernia that necessitated surgical intervention over the last 17 years and evaluated the changes in the number of patients based on the census data. Results: All cases were elderly females. The Howship-Romberg sign was present in 15 patients (68%). Computed tomography (CT) correctly diagnosed 13/15 (87%) of cases in which it was performed prospectively. The median time to surgery was 7.5 ± 5.2 days for those patients with bowel resection, compared to 0.8 ± 1.3 days for those without (P <0.05). The number of patients with obturator hernia has increased with an ageing society. Conclusions: The rising incidence of obturator hernia is probably linked to an ageing society. CT of the pelvis was helpful in obtaining the correct diagnosis. The shorter the delay between admission and surgery, the lower the bowel resection rate. Laparotomy at an early stage is recommended in such patients as it leads to reduced morbidity and mortality.
Obturator hernia is often seen in elderly, thin females and is usually manifested by recurrent bouts of intestinal obstruction and thigh or knee pain on the affected side, without a history of previous abdominal surgery. Patients with small bowel obstruction due to obturator hernia represent 3.9% of all adult abdominal hernia repairs performed over the last 17 years at Nagasaki Prefectural Shimabara Hospital.
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