A Case of Incarcerated Obturator Hernia with Hepatic Portal Venous Gas Treated with Ultrasound-guided Reduction and Elective Surgery

Abstract

A 90-year-old woman was brought to our hospital by an ambulance with complaints of vomiting. Plain abdominal computed tomography showed an incarcerated left obturator hernia with short bowel obstruction and hepatic portal venous gas. She was admitted to our hospital and underwent ultrasound-guided reduction of the incarceration. The next day, computed tomography showed the disappearance of the hepatic portal venous gas, and we decided to perform elective surgery. Under local anesthesia with sedation, radical surgery was performed via the inguinal approach using the direct Kugel method. The postoperative course was good, and she was discharged from our hospital on postoperative day 4. In this case, after the improvement of the overall status of the patient that worsened because of bowel obstruction due to an incarcerated hernia, we were able to conduct an elective surgery more safely. Elective surgery under local anesthesia can be chosen as a treatment when the incarcerated obturator hernia with portal vein gas is reduced without intestinal ischemia and necrosis.