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>Journals >Cirujano General >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)

Language: Español
References: 20
Page: 308-312
PDF: 4. Kb.


Full text




ABSTRACT

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.


Key words: Obturator hernia, intestinal obstruction.


REFERENCIAS

  1. Citado por: Gray SW, Skandalakis JE, Soria RE, Rowe JS Jr. Strangulated obturator hernia. Surgery 1974; 75: 20-7.

  2. Citado por: Gumbs MA, Pandya GS, Kim YH. Obturator hernia. N Y State J Med 1986; 86: 150-1.

  3. Bjork KJ, Mucha P Jr, Cahill DR. Obturator hernia. Surg Gynecol Obstet 1988; 167: 217-22.

  4. Lo CY, Lorentz TG, Lau PWK. Obturator hernia presenting as small bowell obstruction. Am J Surg 1994; 167: 396-8.

  5. Yip AW, AhChong AK, Lam KH. Obturator hernia: a continuing diagnostic challenge. Surgery 1993; 113: 266-9.

  6. Hsu CH, Wang CC, Jeng LB, Chen M. Obturator hernia: a report of eight cases. Am Surg 1993; 59: 709-11.

  7. Ijiri R, Kanamaru H, Yojoyama H, Shirakawa M, Hashimoto H, Yoshino G. Obturator hernia: the usefulness of computed tomography in diagnosis. Surgery 1996; 119: 137-40.

  8. Meziane MA, Fishman EK, Siejelman SS. Computed tomographic diagnosis of obturator hernia. Gastrointest Radiol 1983; 8: 375-7.

  9. Ziegler DW, Rhoads JE Jr. Obturator hernia needs a laparotomy, not a diagnosis. Am J Surg 1995; 170: 67-8.

  10. Arbman G. Strangulated obturator hernia. A simple method for closure. Acta Chir Scand 1984; 150: 337-9.

  11. Tsubono T, Fukuda M, Muto T. A case of bilateral obturator hernias: image diagnosis and description of a retropublic operative approach. Surg Today 1993; 23: 159-63.

  12. Tchupetlowsky S, Losanoff J, Kjossev K. Bilateral obturator hernia: a new technique and a new prosthetic material for repair-case report and review of the literature. Surgery 1995; 117: 109-12.

  13. Beng Ang H. Obturator hernia. Aust N Z J Surg 1970; 210: 36-40.

  14. Rimmer JA, Wharton S, Smedley FH, Horsburgh AG. Bilateral and recurrent obturator hernia. Br J Clin Pract 1990; 44: 784.

  15. Bryant TL, Umstot RK Jr. Laparoscopic repair of an incarcerated obturator hernia. Surg Endosc 1996; 10: 437-8.

  16. Miki Y, Suminura J, Hasegawa T, Misutani S, Yoshioka Y, Sasaki T, et al. A new technique of laparoscopic obturator hernia repair: report of a case. Surg Today 1998; 28: 652-6.

  17. Tucker JG, Wilson RA, Ramshaw BJ, Mason EM, Duncan TD, Lucas GW. Laparoscopic herniorrhaphy: technical concerns in prevention of complications and early recurrence. Am Surg 1995; 61: 36-9.

  18. Cueto García J, Rodríguez Díaz M, Elizalde-Di Martino A, Weber Sánchez A. Incarcerated obturator hernia successfully treated by laparoscopy. Surg Laparosc Endosc 1998; 8: 71-3.

  19. Kozlowski JM, Beal JM. Obturator hernia: an elusive diagnosis. Arch Surg 1977; 112: 1001-2.

  20. Hershmann MJ, Reilly DT, Swift RI. Strangulated obturator hernia: delayed diagnosis is still the rule. J R Coll Surg Edinb 1986; 31: 282-3.






>Journals >Cirujano General >Year 2002, Issue 4
 

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