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Obturator hernia: the Mayo Clinic experience
B S Nasir1, B Zendejas, S M Ali
1Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|December 6, 2011
Summary
Obturator hernia (OH) diagnosis is often delayed. Preoperative computed tomography (CT) may reduce postoperative complications, but immediate surgery is crucial for suggestive symptoms in elderly women.
Area of Science:
- Abdominal Surgery
- Diagnostic Imaging
- Hernia Repair
Background:
- Obturator herniae (OH) are rare surgical conditions with nonspecific symptoms, leading to delayed diagnosis.
- The diagnostic value of preoperative computed tomography (CT) for OH is not well-established.
Purpose of the Study:
- To review the clinical characteristics and outcomes of obturator hernia repairs.
- To compare outcomes between patients who did and did not undergo preoperative CT scans.
Main Methods:
- Retrospective review of 30 patients undergoing OH repair over 58 years.
- Comparison of outcomes based on the use of preoperative computed tomography (CT).
Main Results:
- Most patients presented with bowel obstruction, abdominal/groin pain, or a palpable lump.
- Preoperative CT diagnosed OH in 27% of cases, while clinical diagnosis was only 3%.
- Patients with preoperative CT had fewer postoperative complications (OR 0.8, P=0.04), but other outcomes did not differ significantly.
Conclusions:
- Computed tomography (CT) aids in the preoperative diagnosis of obturator hernia.
- Prompt surgical intervention is recommended for patients presenting with suggestive signs and symptoms, particularly elderly women, to avoid diagnostic delays.
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