A Case of Obturator Hernia with Hepatic Portal Venous Gas

Hisanori Kashizuka, Kiyoshi Kamada, Hiroyuki Kuge, Takashi Yokoyama, Yukihito Niimi, Keijiro Kawasaki and Mitsutoshi Tatsumi

Department of Surgery, Hoshigaoka Koseinenkin Hospital

We report a case of obturator hernia with hepatic portal venous gas (HPVG). A 91-year-old woman with left lower limb pain, abdominal distention, and vomiting was found in plain abdominal computed tomography (CT) to have a small low-density spot in the peripheral liver and enhanced CT 1 hour after plain CT showed dendritic gas indicative of HPVG and an incarcerated obturator hernia. Emergency surgery using a peritoneal approach determined that the jejunum 230 cm proximal to the ileocecal valve was incarcerated in the left obturator foramen, so the necrosed jejunum was resected. Obturator hernia with HPVG is rare, and requires detailed physical examination and CT to ensure a correct diagnosis.

Key words
obturator hernia, hepatic portal venous gas

Reprint requests
Hisanori Kashizuka Department of Surgery, Hoshigaoka Koseinenkin Hospital
4-8-1 Hoshigaoka, Hirakata, 573-8511 JAPAN

Accepted
December 16, 2009

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