Obturator hernia is a rare type of hernia that occurs when part of the abdominal wall pushes through the obturator foramen. It is difficult to diagnose and most common in women over 70 who have lost weight. Symptoms include nausea, vomiting, and abdominal pain. Surgery is the treatment, but death rates are high due to late diagnosis. The Howship-Romberg sign and patient profile are useful tools for diagnosis.
The obturator foramen is a narrow hole partially surrounded by the pubic bone and the base of the hip bone. When part of the abdominal wall pushes through the obturator foramen, it is called an obturator hernia. This type of hernia is extremely rare, very difficult to diagnose, and is most common in women over the age of 70 who have recently lost a significant amount of weight. Symptoms include nausea, vomiting, and possibly abdominal pain. Once diagnosed, an obturator hernia is treated with surgery to remove the hernia.
There are three progressive stages in the development of an obturator hernia. The first step is the infiltration of abdominal fat into the obturator foramen, producing a fat plug. A dimple then develops in the fat plug and migrates inward to form a pouch which then traps a portion of an internal organ, primarily the intestines. Treatment for an obturator hernia is surgery, usually using a laparoscopy, to remove the hernia, then sometimes sutures or a mesh tape are used to narrow the opening and prevent further hernias. If your bowels were damaged, they may need to be repaired during surgery.
Death rates for obturator hernias are often the highest of all abdominal hernias because correct diagnosis is difficult and often not made in time. This type of hernia is so rare that it is typically not considered by doctors when reviewing a case. It also can’t be felt during a physical exam, so CT scans are also needed to see the problem. CT scans don’t always reveal obturator hernia, and the hernia will be missing from the images altogether. Obturator hernias are often misdiagnosed as an intestinal obstruction due to the similarity of symptoms.
Two useful tools for diagnosing an obturator hernia are the Howship-Romberg sign and the patient profile. The Howship-Romberg sign is stabbing pain in the thigh caused by hernia pinching the obturator nerve during hip rotation. This sign, however, is not present in all cases of obturator hernia. An obturator hernia is most often seen in women over the age of 70 who have recently experienced sudden weight loss. Women are prone to obturator hernias because they have wider hips and therefore a larger obturator foramen, and the sudden weight loss reduces the abdominal fat that typically protects the foramen, making this opening even larger and more likely to develop a hernia. hernia.
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