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Obturator hernia and the elderly.

John D Gilbert¹, Roger W Byard^2,3

¹Forensic Science SA, 21 Divett Place, Adelaide, 5000, Australia.

Forensic Science, Medicine, and Pathology

|November 7, 2018

Summary

This summary is machine-generated.

Obscure obturator hernias, often seen in elderly women, can cause fatal small bowel obstruction. This case highlights the importance of considering this rare condition in malnourished patients with gastrointestinal symptoms.

Keywords:

Abdominal pain Death Frailty Intestinal obstruction Obturator hernia

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Area of Science:

Gastroenterology
Geriatrics
Pathology

Background:

Obturator hernias are rare abdominal wall hernias.
They are more common in elderly, multiparous, and malnourished women due to anatomical factors.
These factors include a broader female pelvis, wider obturator canal, lax ligaments, and reduced adipose tissue padding.

Observation:

An 84-year-old woman presented with weight loss, anorexia, and vomiting, leading to acute renal injury from dehydration and malnutrition.
Autopsy revealed a cachectic body with small intestinal obstruction caused by a left obturator hernia.
Additional findings included a poorly differentiated gastroesophageal junction adenocarcinoma and peripheral pulmonary thromboemboli.

Findings:

The patient's death was attributed to small bowel obstruction secondary to a left obturator hernia.
Complicating factors included cachexia from gastroesophageal adenocarcinoma and peripheral pulmonary thromboemboli.
The obturator hernia was a critical, yet often overlooked, cause of obstruction in this elderly patient.

Implications:

This case underscores the significance of obturator hernias as a rare but potentially fatal cause of intestinal obstruction in the elderly.
Early recognition and diagnosis of obturator hernias are crucial for timely intervention.
The findings emphasize the importance of comprehensive autopsy in identifying rare pathologies contributing to mortality, especially in cachectic elderly patients.