Obturator hernia: a difficult diagnosis.
We have presented the case of an elderly woman with severe kyphoscoliosis, osteoarthritis and left knee effusion who had symptoms and signs of intermittent intestinal obstruction. Operation showed a left-sided obturator hernia. In any elderly, debilitated, chronically ill woman, symptoms and signs of recurrent small-bowel obstruction (without a history of abdominal surgery or external hernias) and pain along the ipsilateral thigh and knee (Howship-Romberg sign) should raise suspicion for an obturator hernia. If the hernia is not palpable by physical examination, a CT scan of the pelvis and upper aspect of the thigh would confirm the diagnosis before operation and allow prompt treatment and better chance of patient survival.
Rizk
T A
TA
Department of Surgery, Guthrie Clinic/Guthrie Medical Center, Sayre, PA 18840.
Deshmukh
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N
D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006547:Hernia / Q000175:diagnosis*; D006553:Hernia, Obturator / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis; D007415:Intestinal Obstruction / Q000175:diagnosis; D007813:Laparotomy; D013997:Time Factors