Obturator hernia associated with inclusion body myositis: a case report

Inclusion body myositis is a progressive muscle disease characterized by weakness, specifically in the flexor digitorum profundus and quadriceps muscles, and commonly affects men over 50 years of age. No previous reports have examined the impact of inclusion body myositis on the internal and external obturator muscles. This case study suggests that inclusion body myositis-related fat infiltration of internal and external obturator muscles may contribute to obturator hernia.

We present the case of a 75-year-old Japanese woman admitted for management of an obturator hernia. At age 62 years, her neurological symptoms began with fatigue in the lower legs and dysphagia, and a muscle biopsy confirmed inclusion body myositis. At age 75 years, she presented to the emergency department with sudden right lower abdominal pain. Abdominal computed tomography revealed a fluid-filled small intestine segment between the right obturator externus and pectineus muscles. Thus, she was diagnosed with right obturator hernia. Following surgery, her symptoms improved, allowing for hospital discharge.

Inclusion body myositis-related muscle atrophy is not well documented. Beyond its characteristic muscle weakness and dysphagia, obturator hernia may be a complication in patients with inclusion body myositis. Thus, considering the potential severity of obturator hernias, clinicians should remain vigilant for symptoms other than muscle weakness.