>Year 2002, Issue 4
Gómez CX, Vega BM, Rojas RG, Guarneros ZJE, Cueto GJ, Guzmán NL, Dergal BE
Obturator hernia: Report on four patients. Experience at the American British Cowdray Hospital
Cir Gen 2002; 24 (4)
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Objective: Intestinal obstruction due to obturator hernia is not frequent and is associated to a high mortality rate; it occurs mainly in elderly women (70-90 years) associated to weight loss and extreme prostration. The objective of this report is to present our experience in the diagnosis and surgical treatment of four patients with obturator hernia, complicated with intestinal obstruction.
Setting: Third level health care hospital.
Description of the cases: Four patients with obturator hernia diagnosis were treated in the last five years (1996-2000), three women and one man. Two hernias were of the Richter type located on the right side, average age was of 68 years, range 40 to 86 years, preoperative diagnosis was performed through abdominal CT in two patients. Laparoscopy with reduction of the herniary sac and placement of a propylene mesh was performed in one patient, the remainder patients were subjected to exploratory laparotomy, performing intestinal resection with primary anastomosis, and in these three patients the obturator defect was repaired using non-absorbable suture. Oral feeding was started from 2 to 4 days after surgery; average hospital stay was of 5 days. Associated morbidity was chronic obstructive pneumopathy in two cases. There was a direct relation between the delay in surgical treatment and intestinal resection, with a larger hospital stay and later start of oral feeding. No deaths occurred, one patient coursed with infection of the surgical wound.
Conclusion: The presence of an obturator hernia complicated with intestinal obstruction can be suspected clinically and corroborated through CT. Early surgical treatment reduces complications.
||Obturator hernia, intestinal obstruction.
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>Year 2002, Issue 4