A Case of Metaclronosis, Bilateral Obturator Hernia

Nobuhiro Tokunaga, Hisashi Shinohara, Hidetane Onishi, Takashi Bettsho, Hiroaki Kurihara, Mitsuo Mori, Tsong-Hong Kuo, Natsuya Katada

Department of Surgery, Okura National Hospital

An 85-year-old weak female was admitted with the complaint of continuous pain extending down the inner surface of her right thigh to her right knee. An abdominal roentgenogram in the upright position revealed dilated loops of small intestine with air fluid levels. She was initially treated conservatively, and then an exploratory operation was performed through a low midline incision. The operative diagnosis was a right incarcerated obturator hernia. The patient did well up to 21 weeks after the operation. She returned to the hospital with vomiting and epigastralgia. She also complained of continuous pain over the medial aspect of the left thigh upon admission. The previous incision site was opened and she was found to have a left incarcerated obturator hernia. Bilateral obturator hernias occurring at different times are rare, this being the 4th reported case. In all other reported cases, an obturator hernia on the contralateral side occurred within 6 months after reduction of the hernia on the first side. The abdominal aspect of the contralateral obturatory foramen should be inspected during laparotomy for obturator hernias.

Key words
obturator hernia, strangulated intestinal obstruction, incarcerated hernia

Reprint requests
Nobuhiro Tokunaga Department of Surgery, Okura National Hospital
2-10-1 Okura, Setagaya-ku, Tokyo, 157 JAPAN

Accepted
July 3, 1991

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