title: Obturator hernia: current diagnosis and treatment.
abstract: BACKGROUND
  Obturator hernia is a rare pelvic hernia for which both diagnosis and therapy are difficult. Because symptoms are nonspecific and specific physical findings are often obscure, diagnosis of obturator hernia is often delayed until laparotomy for bowel obstruction. Strangulation is frequent, and mortality remains high (25%). Primary closure of the hernia defect is difficult because adjacent tissues are not easily mobilized. Although a variety of techniques have been described, surgical repair has not been standardized.
  
  
  METHODS
  We report a case of bilateral obturator hernia with incarceration in association with bilateral femoral hernia in which these problems were satisfactorily addressed.
  
  
  RESULTS
  The hernias were diagnosed by computed tomography (CT) scan and repaired with synthetic mesh placed in the preperioneal space. This technique is well suited to unilateral and bilateral combinations of obturator, inguinal, and femoral hernias. CT scan in the work-up of severe gastrointestinal symptoms with weight loss may lead to a diagnosis of occult hernia, thereby allowing elective repair and, hopefully, a reduction in mortality risk.
  
  
  CONCLUSIONS
  We recommend CT scan for suspected obturator hernia and preperitoneal mesh repair of noninfected cases.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Bergstein
authors.forename: R E
authors.initials: RE
authors.lastname: Condon
mesh_terms: D000368:Aged; D005260:Female; D006550:Hernia, Femoral / Q000150:complications / Q000601:surgery; D006553:Hernia, Obturator / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D015996:Survival Rate; D014057:Tomography, X-Ray Computed