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Obturator hernia: the usefulness of computed tomography in diagnosis
R Ijiri1, H Kanamaru, H Yokoyama
1Department of Surgery, Fujieda Shida General Hospital, Fujieda City, Japan.
Background:
Delay in diagnosis and treatment of the rare obturator hernia often leads to high resection and mortality rates. Reviews of the clinical courses and the reliability of computed tomography (CT) in early diagnosis are reported.
Methods:
Seventeen patients with obturator hernias were treated between April 1983 and December 1994. Except for one man, all were emaciated women who had undergone an average of 4.7 live deliveries. The mean age was 79.9 years.
Results:
All patients had small bowel obstruction symptoms. Howship-Romberg sign was present in 11 patients. Twelve cases were correctly diagnosed before operation. After the introduction of CT in the diagnosis of suspected hernia cases, preoperative diagnosis was made on 9 of the 10 patients (90%) and CT was performed on 8 patients with 100% accuracy.
Conclusions:
Definite and early diagnosis is possible with the awareness of the clinical courses of this hernia and by performing CT on suspected cases.