title: Obturator hernia--a condition seldom thought of and hence seldom sought.
abstract: OBJECTIVE
  Obturator hernia is an extremely rare type of hernia with an incidence of less than 1% of all abdominal wall hernias occurring predominantly in elderly females characterized by protrusion of the intra-abdominal viscera into the obturator foramen. It presents with pain along the medial aspect of the thigh referred to the knee due to compressed obturator nerve and sometimes as an uncommon cause of intestinal obstruction. It remains a clinical diagnostic dilemma and often perplexing the decision for surgery. This explanatory review emphasizes and illuminates its various facets under the rationale of its diagnosis and management to familiarize surgeons with the condition.
  
  
  METHODS
  The data for the present review was obtained by searching in PubMed and other databases using key terms "obturator hernia", "abdominal hernia", "intestinal obstruction", and "Howship-Romberg sign". Many original articles, reviews, and case reports were selected.
  
  
  RESULTS
  Since it is very rare that a mass can be found on inspection of the medial aspect of the thigh and the clinical signs are not always present, hence obturator hernia is a condition which leads to both difficult and delayed clinical diagnosis and consequently having a significant morbidity and mortality rates, especially in the elderly.
  
  
  CONCLUSIONS
  Obturator hernia should always be in the differential diagnosis in septuagenarian to nonagenarian patients with nonspecific signs and symptoms of intestinal obstruction. Computed tomography of abdomen and pelvis has been found to be the gold standard for preoperative diagnosis and this condition necessitates immediate surgical reduction and repair of the defect either by open or laparoscopic approach.
authors.affiliation: Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
authors.forename: M Tasleem
authors.initials: MT
authors.lastname: Mandarry
authors.forename: Shao-Bing
authors.initials: SB
authors.lastname: Zeng
authors.forename: Zheng-Qiang
authors.initials: ZQ
authors.lastname: Wei
authors.forename: Caiquan
authors.initials: C
authors.lastname: Zhang
authors.forename: Zi-Wei
authors.initials: ZW
authors.lastname: Wang
mesh_terms: D006553:Hernia, Obturator / Q000453:epidemiology / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D006801:Humans; D014057:Tomography, X-Ray Computed