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Incarcerated obturator hernia

Case contributed by Amit Chacko
Diagnosis certain

Presentation

4 day history of vomiting, constipation and abdominal pain.

Patient Data

Age: 90 years
Gender: Female

There is distension of multiple small bowel loops noted within the central abdomen. Dilated loops of bowel can be tracked into the left pelvis, where there is an abrupt caliber change. A loop of bowel passes through the obturator canal and there is incarceration noted at this site. There is diverticular disease in the large bowel. There is no free gas in the abdomen.

Impression: Acute small bowel obstruction, secondary to an incarcerated left sided obturator hernia

Case Discussion

The patient was taken for emergency laparotomy with surgical findings consistent with the radiology. 10cm of small bowel was resected with an end to end anastomosis. The patient had an uncomplicated recovery and was discharged six days later.

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