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Intestinal Obstruction Secondary to Strangulated Richter Type Obturator Hernia: A Case Report
Suresh Maharjan1, Samrat Shrestha1, Deepika Rijal1
1Department of General Surgery National Academy of Medical Sciences, NAMS, Bir Hospital Kathmandu Nepal.
Clinical Case Reports
|October 7, 2025
Summary
Obturator hernia, a rare cause of bowel obstruction in the elderly, presents with vague symptoms making diagnosis difficult. This case highlights the importance of CT scans for early detection and surgical intervention to reduce mortality.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiology
Background:
- Obturator hernia is a rare internal hernia associated with high morbidity and mortality, particularly in the elderly.
- Diagnosis is often delayed due to nonspecific and atypical clinical presentations.
Purpose of the Study:
- To report a case of obturator hernia in an elderly female.
- To emphasize the diagnostic challenges and the role of imaging in timely diagnosis and management.
Main Methods:
- A case report of an elderly female presenting with abdominal pain and distension.
- Computed tomography (CT) scan for diagnosis.
- Emergency laparotomy for surgical repair.
Main Results:
- CECT abdomen and pelvis revealed dilated small bowel loops and a transition point due to right obturator hernia.
- Emergency laparotomy confirmed a strangulated obturator hernia.
- Resection of gangrenous ileum with anastomosis and primary closure of the obturator defect was performed.
Conclusions:
- Obturator hernia is a rare condition often presenting as partial bowel obstruction, predominantly in elderly females.
- CT scan is the most sensitive imaging modality for diagnosis.
- Prompt surgical intervention is crucial for reducing morbidity and mortality.
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