A Case of Right Obturator Hernia with Prolapsed Appendix Treated with TAPP

Abstract

The patient was a 37-year-old woman with prolapse of the appendix through a right obturator hernia and pain in the right thigh, identified during postoperative follow-up computed tomography (CT) for Marfan syndrome. Clinical examination revealed right thigh pain, indicating a positive Howship-Romberg sign. Further laboratory blood test results showed elevated prothrombin time-international normalized ratio (PT-INR) due to the patient being on warfarin after mitral valve replacement, but no other abnormalities were noted. Repeat CT at our institute confirmed a right obturator hernia, but no prolapse of the appendix or other organs was observed. The patient underwent transabdominal preperitoneal repair (TAPP), had a good postoperative course, and was subsequently discharged on postoperative day 4 after confirming that the PT-INR was in the therapeutic range. Postoperatively, there was an improvement in the Howship-Romberg sign. This report focuses on a rare case of obturator hernia involving prolapse of the appendix in a young woman and reviews relevant literature on these findings.