Femoral Abscess Formation after Surgery for Incarcerated Obturator Hernia with Small Bowel Perforation—A Case Report—

Abstract

A 75-year-old woman presented with bilateral femoral discomfort and pain. She was diagnosed with an incarcerated obturator hernia and underwent an unsuccessful noninvasive reduction. Consequently, emergency surgery was performed. Laparoscopic intra-abdominal observation revealed a Richter's hernia of the ileum incarcerated into the right obturator foramen. The incarcerated intestine was perforated and resected. Owing to the hardness of the hernia sac, it could not be opened. After washing, a drain was inserted into the hernia sac, and uterine cricothyrotomy was performed. The patient was discharged from the hospital on the 9th postoperative day, but 11 days after discharge, she developed high fever and chills and became unconscious, and was brought to our hospital. Her vitals implied that she was in shock, and she had mild tenderness in the lower abdomen. Contrast-enhanced computed tomography (CT) showed an abscess extending from the right pelvic floor to the thigh musculature. CT-guided drainage and incision of the femoral region was performed. Obturator hernias associated with intestinal perforation may be complicated owing to the formation of a femoral abscess after surgery for obturator hernia. Prompt and safe drainage should be performed to manage residual abscesses.