Traumatic obturator foramen hernia. A rare aetiology of a rare condition: A case report

Obturator hernias (OH) are rare, accounting for less than 0.05% of all hernias. The aetiology is usually attributed to chronically raised intra-abdominal pressure or cachexia with poor muscle mass. This case report describes a traumatic obturator hernia, an exceptionally rare aetiology of an already rare surgical condition. There are no previous reports of a traumatic obturator hernia in the current literature. This case reports upon the presentation, operative findings and management of a 48 year old male with abdominal and pelvic trauma following a motor bike collision. Laparotomy findings included a right sided traumatic incarcerated obturator foramen hernia with the comminuted pubic rami fracture trapping and piercing ileum within the hernia. In retrospect, the hernia was visible on CT scan. The hernia was repaired using biological mesh which was covered with adjacent peritoneum. As with much of trauma surgery, the management of this case required reliance on general principles and real time problem solving to address an issue not previously experienced by the operator, and not previously reported on in the current literature.