Obturator hernia presenting with intestinal obstruction: A case study and CT imaging insights

Obturator hernia is a rare but clinically significant cause of intestinal obstruction, particularly in elderly, thin women due to their anatomical predisposition. We present the case of a 79-year-old female with a history of hypertension and hip arthroplasty who developed acute abdominal pain, vomiting, and absence of flatus and bowel movements. Imaging with contrast-enhanced computed tomography (CT) revealed a right obturator hernia containing a small bowel loop, causing intestinal obstruction without signs of ischemia. The patient underwent urgent intraperitoneal obturator herniorrhaphy, during which an incarcerated small bowel loop with congestive changes was identified and found to be viable, recovering fully after reduction. This case highlights the importance of including obturator hernia in the differential diagnosis of bowel obstruction in elderly patients and demonstrates the pivotal role of CT imaging in achieving timely and accurate diagnosis.