The Predictors for Intestinal Ischemia due to an Incarcerated Obturator Hernia

Abstract

Background : The currently reported indicators of intestinal ischemia in incarcerated obturator hernia surgery include “elapsed time after onset”, “incarcerated intestinal tract diameter”, and “incarcerated intestinal tract content CT value”. This study investigated whether these indicators are predictors of intestinal ischemia in surgical cases of incarcerated obturator hernia at our hospital. Methods : Between 2010 and 2022, 24 patients underwent surgery for incarcerated obturator hernia at our hospital. Of these, 8 patients underwent bowel resection due to intestinal ischemia (resection group : emergency surgery was performed for all cases), while 16 did not undergo bowel resection (non-resection group : 7 cases of emergency surgery, 9 cases of elective surgery after non-invasive reduction). We investigated three predictors in both groups. Result : The median time from onset to surgery or release of the incarceration was 36 hours in the resection group and 6 hours in the non-resection group, with no statistically significant differences (p=0.07). The diameter of the incarcerated intestine was 3.5 cm in both groups (resected vs. non-resected, p=0.99). The mean CT value of the incarcerated bowel content was 22 HU in the resected group and 8.3 HU in the non-resected group. This difference was statistically significant (p=0.04). Conclusion : Incarcerated intestinal content CT values may be a predictor of intestinal ischemia during non-invasive reduction.