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Obturator canal fat plug: a pre-hernial condition?

C J Callaghan1, R H Whitaker

  • 1Department of Anatomy, University of Cambridge, Cambridge CB2 3DY, United Kingdom.

Clinical Anatomy (New York, N.Y.)
|July 12, 2002
PubMed
Summary
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Obturator hernias are rare but deadly, often diagnosed late in the elderly. This study found that pre-peritoneal fat plugs in the obturator canal, common in females, support the hypothesis of their role in hernia development.

Area of Science:

  • Anatomy
  • Surgical Pathology
  • Geriatric Medicine

Background:

  • Obturator hernias are rare but have high mortality due to delayed diagnosis, particularly in the elderly.
  • The pathogenesis is hypothesized to involve pre-peritoneal fat invagination forming a 'fat plug' within the obturator canal.
  • This fat plug may progress to a clinical obturator hernia under increased intra-abdominal pressure or with weight loss.

Purpose of the Study:

  • To investigate the frequency of obturator canal fat plugs in cadavers.
  • To examine the validity of the current hypothesis regarding obturator hernia pathogenesis.
  • To analyze the sex and side distribution of these fat plugs.

Main Methods:

  • Dissection of 95 Caucasian cadaveric hemi-pelvises (47 male, 48 female).

Related Experiment Videos

  • Analysis of specimens for the presence, size, and location of fat plugs within the obturator canal.
  • Comparison of findings with reported data on obturator hernias.

    • Main Results:

    • Fat plugs were identified in 21 out of 95 canals (22%).
    • Fat plugs were more frequent in females (71%) and on the right side (62%).
    • Peritoneal dimples were observed overlying fat plugs in two specimens; no visceral herniations were found.

    Conclusions:

    • The distribution of fat plugs in the obturator canal supports the hypothesis that they are pre-hernial structures.
    • While fat plugs themselves may not be a high-risk condition, overlying dimples could indicate potential hernia formation.
    • Further research may elucidate the precise role of these anatomical variations in obturator hernia development.