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Case report: Incarcerated obturator hernia, initially presenting as right hip pain!
A Al Ghrebawi1, G G Koning2, N Dogan3
1Surgery Department, Sub-division of Digestive Surgery, Teaching Hospital EUREGIO, Albert-Schweitzer-Straße 10, Nordhorn, Germany.
Obturator hernia, a rare cause of hip pain, can be diagnosed with CT scans. Early surgical intervention is crucial to prevent complications like intestinal necrosis, especially in elderly women.
Area of Science:
- Abdominal Surgery
- Diagnostic Imaging
- Hernia Surgery
Background:
- Obturator hernia (OH) is a rare external abdominal hernia, accounting for 0.07%-1% of all hernia cases.
- Diagnosis can be delayed due to non-specific clinical presentations, necessitating advanced imaging like CT scans.
- Emergency surgical treatment is vital as intestinal incarceration can lead to acute necrosis.
Observation:
- An 82-year-old woman presented with right hip joint pain, initially suspected as arthritis.
- A CT scan revealed an incarcerated right-sided obturator hernia causing intestinal ischemic obstruction.
- The patient underwent emergency laparotomy for treatment.
Findings:
- The case highlights the diagnostic challenge of obturator hernia presenting as hip pain, leading to orthopedic admission.
- The Howship-Romberg sign is a key clinical indicator for obturator hernia, particularly in at-risk populations.
- Prompt diagnosis and surgical intervention are critical for favorable patient outcomes.
Implications:
- This case underscores the importance of considering obturator hernia in elderly patients with unexplained hip pain.
- Awareness of the Howship-Romberg sign can expedite diagnosis and prevent severe complications.
- Timely management of obturator hernia significantly reduces risks of perforation, necrosis, and sepsis.
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