The obturator hernia: Difficult to diagnose, easy to repair

Background: The aim of this paper is to present a simple method for obturator hernia repair in two cases with strangulated obturator hernia. Methods: The authors report on two cases of mechanical bowel obstruction due to incarcerated obturator hernia in elderly, thin women. Both patients presented with clinical and radiological signs of small bowel obstruction. Neither of them had the Howship-Romberg or Hannington-Kiff sign. Results: At laparotomy, incarcerated small bowel in a right-sided obturator hernia was observed in both patients. The small bowel was not necrotic, and no bowel resection was performed. The hernial defect was closed in two layers with interrupted and purse-string nonabsorbable sutures. Conclusions: Obturator hernia is rare and difficult to diagnose. Often the diagnosis is reached only at laparotomy for small bowel obstruction. The double-layer repair with interrupted and purse-string nonabsorbable sutures could be useful, especially in emergency laparotomies for incarcerated obturator hernia. © Springer-Verlag 2004.