Global Journal of Surgery
ISSN (Print): 2379-8742 ISSN (Online): 2379-8750 Website: http://www.sciepub.com/journal/js Editor-in-chief: Baki Topal
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Global Journal of Surgery. 2013, 1(4), 50-52
DOI: 10.12691/js-1-4-3
Open AccessCase Report

Richter Type of Incarcerated Obturator Hernia: Misery Still Continues

Kumar Jayant1, , Rajendra Agarwal2 and Swati Agrawal3

1Department of Surgery, Sudha Hospital &Medical Research Centre, Talwandi, Kota, Rajasthan, India

2Head of Department of Surgery, Sudha Hospital &Medical Research Centre Kota, Rajasthan, India

3Sudha Hospital &Medical Research Centre Kota, Rajasthan, India

Pub. Date: December 08, 2013

Cite this paper:
Kumar Jayant, Rajendra Agarwal and Swati Agrawal. Richter Type of Incarcerated Obturator Hernia: Misery Still Continues. Global Journal of Surgery. 2013; 1(4):50-52. doi: 10.12691/js-1-4-3

Abstract

Obturator hernia is a rare type of hernia which accounts for only 0.07–1.4% of all intra-abdominal hernias and 0.2–5.8% of small-intestinal obstructions. It develops predominantly in elderly underweight women. It has nonspecific early symptoms, so these hernias are usually discovered only after they have become incarcerated. Incarcerated obturator hernias are usually discovered on abdominal computed tomography scan or emergency surgery due to bowel obstruction. Here we present a case of a 65-year-old female who presented with intermittent abdominal pain, distension and nausea for last 3 days. She was a known case of hypothyroidism, taking Levothyroxine in inadequate dose. Her intial abdominal Xray was showing few air-fluid level with air present in rectum. She was initially managed conservatively but later developed features of peritonitis for which she was operated. In laparotomy, Richter type of right-sided incarcerated obturator hernia was discovered with a small necrotic area and perforation of small bowel. Bowel resection was performed and obturator hernia was closed with interrupted sutures. The patient recovered without complications. Obturator hernia, due to its rarity and nonspecific early symptoms, can still be misleading even to the most experienced clinicians. Delay in diagnosis of obturator hernia can lead to bowel necrosis and perforation with significant postoperative morbidity and mortality.

Keywords:
richter obturator hernia strangulated

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