A CASE REPORT: SMALL BOWEL OBSTRUCTION DUE TO OBTURATOR HERNIA

Abstract

Introduction: The obturator hernia is an uncommon cause for small bowel obstruction. It is classically described in thin elderly women. Delay to diagnosis may result in strangulation and gangrenous bowel at subsequent laparotomy The classically described signs, whilst useful when present, are absent in greater than 50% of cases, and preoperative diagnosis is made on radiological imaging. A 79-year-old female presented Case report: to hospital with a 2 – days history of vomiting, generalized dull aching abdominal pain and enable to pass stool for 2 days. Past medical history included scoliotic deformity in lumbar spine and previously operated for tubal ligation before 32 years. Laparotomy, bowel resection and suture hernia repair were undertaken. A subsequent presentation of small bowel obstruction was due to recurrence of the obturator hernia. However, resolved without operative management. A very high index of suspicion is required when Discussion: presented with the case of small bowel obstruction in an elderly female patient. One must therefore, also consider that any subsequent presentations of small bowel obstruction may be due to recurrence of the obturator hernia, the differential being adhesive bowel obstruction, and delay to denitive treatment is associated with poorer prognosis. A high index of suspicion is required to diagnose an obturator hernia clinicall Conclusion: y. Failure to do so results in greater mortality and morbidity. Early cross-sectional imaging can make the diagnosis and lead to earlier surgical repair. A diagnostic challenge, an obturator hernia is a rare cause of small bowel obstruction. Delay in diagnosis is associated with adverse outcome. Computed tomography scan has proved invaluable to early detection and repair.