A Case of Obturator Hernia Treated as Neuralgia for a Long Time

Abstract

We report a case of obturator hernia which had been treated for a long time as left inguinal or femoral neuralgia caused by lumbar spine deformity.
An 84-year-old woman was admitted to the hospital complaining of abdominal pain, vomiting, and left inguinal pain. The abdominal radiograph showed multiple air-fluid levels and pelvic CT showed an abnormal soft tissue mass between the left obturator externus and pectinius muscles. The patient was diagnosed with a strangulated left obturator hernia, and underwent surgery immediately. Repositioning of the incarcerated ileum was performed and the bilateral hernial orifices were closed directly via an abdominal approach.
The patient had been complaining of left inguinal and femoral pain for about one year. Although she had been treated in orthopedics for left femoral or inguinal neuralgia caused by lumbar spine deformity, the pain had reappeared intermittently until the operation for obturator hernia. After the operation her pain disappeared. From this clinical course the pain would appear to have been caused not by the neuralgia but by the strangulated obturator hernia.
It is important to suspect a strangulated obturator hernia in elderly, thin females complaining of femoral or inguinal pain.