Seven Cases of Obturator Hernia

Yoshichika okamoto, Kazuo Suzuki, Haruhiko Chigira, Takehito Katoh, Yoshihisa Shibata, Hiroshi Kurino, Kenji Sakaguchi, Yasushi Kitoh, Tomoko Seki, Yasuji Mokuno, Katsushi Yoshida, Satoshi Kamiya

Department of Surgery, Toyohashi Municipal Hospital

From November 1988 through January 1994, six patients with seven lesions of obturator hernia underwent surgery in Toyohashi Municipal Hospital. All the patients, ranging from 77 to 90 years old, were women, and all showed ileus symptoms. As concerns Howship-Romberg sign (H-R sign), patients had complaints in their lower extremities in six cases (86%), and objective findings were observed preoperatively in two of them. The period between the initial symptom and the operation ragned from 2 to 19 days (mean 8.1 days). Preoperative diagnosis of obturatory hernia was made in four cases (57%), where H-R sign and clinical images such as CT scan, ultrasonography and X-ray contrast examination of the intestine through a long tube were useful. The incarcerated bowel was the ileum in all cases: four lesions in the left obturator foramen and three in the right. Resection of the bowel was done for four cases, and the remaining cases without bowel resection were treated with surgery relatively soon after the initial symptom. In the treatment of aged women presenting ileus, it is important to take obturator hernia into consideration. H-R sign, CT scan and ultrasonography are useful for early diagnosis of obturator hernia.

Key words
obturator hernia, diagnostic imaging, ileus

Reprint requests
Yoshichika okamoto The First Department of Surgery, Nagoya University School of Medicine
65 Tsurumai-cho, Showa-ku, Nagoya, 466 JAPAN

Accepted
May 17, 1995

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