title: Obturator hernia in an ageing society.
abstract: BACKGROUND
  Obturator hernia is an important cause of small bowel obstruction and is associated with difficult diagnosis and high mortality.
  
  
  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.
authors.affiliation: Department of Surgery, Nagasaki Prefectural Shimabara Hospital, Nagasaki, Japan. haraguci@mb.ejnet.ne.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Haraguchi
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Matsuo
authors.forename: Kengo
authors.initials: K
authors.lastname: Kanetaka
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tokai
authors.forename: Takashi
authors.initials: T
authors.lastname: Azuma
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019352:Censuses; D005260:Female; D006553:Hernia, Obturator / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008485:Medical Audit; D017063:Outcome Assessment, Health Care; D011157:Population Dynamics; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed