A rare case of incarcerated obturator hernia in an elderly female: Importance of timely diagnosis and choice of surgical intervention – open or laparoscopic

Abstract

Obturator hernia is a rare clinical condition, mainly affecting the elderly and frail patients. It is often challenging to diagnose, and carries a significant morbidity and mortality risk. We aim to highlight the importance of timely and adequate diagnosis followed by early intervention that can be done as open or laparoscopic. Furthermore, through a literature review, we intend to compare two types of surgical approaches (open vs. laparoscopic). Herein, we present the case of an 83 years old female admitted as an emergency with right lower quadrant, colicky abdominal pain, followed with nausea, vomiting and constipation. Computed Tomography (CT) scan revealed a right-sided incarcerated obturator hernia with proximal bowel distension. Emergency surgery was performed, emphasizing the importance of early intervention to prevent bowel necrosis and the need for bowel resection; due to asthma we opted for open approach. Intraoperatively, a right-sided incarcerated obturator hernia was confirmed, with a segment of small bowel herniating through the obturator canal. We discuss the role of CT scanning in diagnosis, the necessity of prompt surgical management, and the possibility of open and laparoscopic approaches through a literature review. The choice between open and laparoscopic approaches should be individualized, considering the patient’s clinical status and the potential risks and benefits of each technique. Further research comparing the long-term results of open versus laparoscopic repair in incarcerated obturator hernia is something to be explored in the efforts of achieving the highest standards of patient care and maximizing the chances for an optimal treatment outcome. © 2024, Professional Medical Publications. All rights reserved.