Presentation
Abdominal pain, nausea, vomiting.
Patient Data
Oral contrast in stomach and nondilated proximal small bowel, with slow transition to dilated, fluid-filled, unopacified distal small bowel. The obstruction is due to a right obturator hernia.
Mesenteric edema and small ascites. Decompressed distal-most small bowel and colon.
POSTOPERATIVE DIAGNOSIS:
Incarcerated right obturator hernia.
PROCEDURE:
Laparoscopic reduction of incarcerated right obturator hernia and high ligation of obturator hernia sac. Small bowel was viable.
Case Discussion
Obturator hernias occur through the obturator canal, which contains the neurovascular bundle and is about 2-3 cm long. It is more common in elderly females (as in this case) likely due to increased pelvic laxity, and can result in small bowel incarceration and need for urgent surgical attention.
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