Laparoscopic total extraperitoneal repair of preoperatively diagnosed bilateral obturator and incidental bilateral femoral herniae.
Obturator hernia (OH), a rare type of hernia, is associated with high morbidity and mortality. Diagnosis is often delayed as clinical symptoms are typically non-specific. OH is frequently associated with other occult inguinopelvic herniae. Early diagnosis is vital to decrease morbidity and mortality. We report the case of a 75-year-old woman who presented to the surgical outpatients' department with non-specific bilateral groin pain radiating to the thighs. CT of the pelvis demonstrated bilateral OH with no radiological evidence of bowel obstruction. Semiurgent elective laparoscopic total extraperitoneal mesh repair was performed. Intraoperative findings confirmed bilateral obturator herniae as well as incidental bilateral femoral herniae. This case highlights the need for a high index of suspicion for such concomitant hernias that, in the presence of OH, may only be identified intraoperatively.
Department of Surgery, St Luke's Hospital Kilkenny, Kilkenny, Ireland.
Muhammad Usman
MU
Malik
Department of Surgery, St Luke's Hospital Kilkenny, Kilkenny, Ireland.
Tara M
TM
Connelly
Department of Surgery, St Luke's Hospital Kilkenny, Kilkenny, Ireland.
Mustafa
M
Hamid
Department of Surgery, St Luke's Hospital Kilkenny, Kilkenny, Ireland.
Frederik
F
Pretorius
D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery; D000368:Aged; D057210:Delayed Diagnosis; D017558:Elective Surgical Procedures; D005260:Female; D006119:Groin / Q000473:pathology* / Q000601:surgery; D006550:Hernia, Femoral / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006553:Hernia, Obturator / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D033162:Incidental Findings; D010535:Laparoscopy; D008566:Membranes / Q000473:pathology*; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D010384:Pelvic Bones; D010388:Pelvis / Q000473:pathology* / Q000601:surgery; D013526:Surgical Mesh