When rarity meets emergency: obturator hernia with incarcerated small bowel loop

Obturator hernia is a rare cause of bowel obstruction that predominantly affects elderly, thin women. Because clinical manifestations are often nonspecific, diagnosis is frequently delayed, leading to increased morbidity and mortality. We report the case of an 89-year-old woman who presented with acute pelvic pain radiating to the right lower limb and bilious vomiting. Contrast-enhanced computed tomography (CT) revealed a right-sided incarcerated obturator hernia involving the small bowel, with associated signs of bowel obstruction and suspected ischaemia. The patient underwent emergency surgery with a favourable postoperative outcome. Obturator hernia remains a diagnostic challenge because of its rarity and nonspecific clinical presentation. CT is the imaging modality of choice for establishing the preoperative diagnosis, assessing bowel viability, and guiding surgical management. Early recognition and prompt surgical intervention are essential to prevent strangulation and bowel necrosis. Obturator hernia should therefore be considered in the differential diagnosis of bowel obstruction in elderly women, as timely imaging and surgical treatment are crucial for improving patient outcomes.