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Obturator hernia: current diagnosis and treatment
1Department of Surgery, Medical College of Wisconsin, Milwaukee, USA.
Surgery
|February 1, 1996
Summary
Obturator hernias are rare and difficult to diagnose, often leading to delayed treatment and high mortality. Computed tomography (CT) scans and preperitoneal mesh repair offer a viable solution for these challenging pelvic hernias.
Area of Science:
- General Surgery
- Abdominal Wall Reconstruction
- Pelvic Anatomy
Background:
- Obturator hernia is a rare pelvic hernia with nonspecific symptoms, complicating diagnosis and treatment.
- Delayed diagnosis is common, often occurring during laparotomy for bowel obstruction, with a high mortality rate (25%).
- Surgical repair is challenging due to difficulties in mobilizing adjacent tissues and a lack of standardized techniques.
Observation:
- A case of bilateral obturator hernia with incarceration, associated with bilateral femoral hernia, was successfully managed.
- Computed tomography (CT) scan was instrumental in diagnosing the complex hernias.
- The hernias were repaired using synthetic mesh placed in the preperitoneal space.
Findings:
- Preperitoneal mesh repair is effective for unilateral and bilateral obturator, inguinal, and femoral hernias.
- CT scan can diagnose occult hernias in patients with severe gastrointestinal symptoms and weight loss.
- Early diagnosis via CT scan allows for elective repair, potentially reducing mortality risk.
Implications:
- CT scan is recommended for suspected obturator hernias.
- Preperitoneal mesh repair is a recommended surgical approach for noninfected cases of obturator hernia.
- This approach may improve outcomes for complex and bilateral pelvic hernias.
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