A Case of Small Bowel Perforation Associated with Recurrence of an Incarcerated Obturator Hernia After Non-invasive Reduction

Abstract

A 90-year-old woman was admitted to our hospital for vomiting and anorexia 28 months after non-invasive reduction of an incarcerated obturator hernia. Abdominal computed tomography (CT) revealed recurrence of a left incarcerated obturator hernia, but non-invasive reduction of the hernia under ultrasonographic guidance proved unsuccessful. The mean CT value of the incarcerated intestinal hernia contents was 9.76 HU at the time when the non-invasive reduction proved successful and 23.7 HU at the time of the intestinal resection. We performed laparoscopic repair of the hernia defect and open wedge resection of the perforated small intestine. We suggest that the CT values of the contents of an incarcerated intestinal hernia may be a predictor of intestinal ischemia. Although the recurrence rate of obturator hernia is relatively low according to the literature, we suggest that elective repair should be performed after non-invasive reduction.