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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

Summary

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.

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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).
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.

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