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.
Department of Surgery, Guthrie Clinic/Guthrie Medical Center, Sayre, PA 18840.
T A
TA
Rizk
N
N
Deshmukh
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