Abstract
We report an emergency operation case of bilateral obturator hernia with impaction of the small intestine.
An 87-year-old woman was referred to our hospital because of abdominal fullness and left femoral pain. She presented the Howship-Romberg sign on the left side. Enhanced CT examination revealed herniation through the obturator foramen in which the small intestine was impacted. We diagnosed the case as bilateral strangulated obturator hernia and an emergency operation was done. Upon laparotomy, the small intestine which had impacted in the bilateral foramens was identified and reduced by hand manipulation. The parts of the small intestine impacted in the foramens showed intramural hematomas but no ischemic changes were seen. A difference in the intestinal diameter noted at the left incarcerated portion of the left obturator foramen might cause the intestinal obstruction. A left femoral hernia was found as well. We performed the tension free mesh repair method without resection of the hernia sac and impacted small intestine. She has had no symptoms of recurrent hernia with good quality of life. Although obturator hernia is sometimes encountered as a cause of intestinal obstruction in aged women, strangulated obturator hernia occurred bilaterally is rare.
