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Heo, Kang, Chung, Hwang, Seungbum, Lee, and Park: Experiences on Obturator Hernia and Review of Korean Cases
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 78(1): 41-50.

Published online: 8 January 2010

DOI: https://doi.org/10.4174/jkss.2010.78.1.41

Experiences on Obturator Hernia and Review of Korean Cases

Seung Chul Heo, M.D., Ph.D.1, 3, Sung-Bum Kang, M.D., Ph.D.1, 4, Jung Kee Chung, M.D., Ph.D.1, 3, Ki-Tae Hwang, M.D., Ph.D.3, Ryoo Seungbum, M.D., Ph.D.1, 2, Taek-Gu Lee, M.D., Ph.D.4, Kyu-Joo Park, , 1, 2

1Department of Surgery, Seoul National University College of Medicine, Korea.

2Department of Surgery, Seoul National University Hospital, Korea.

3Department of Surgery, Boramae Hospital, Seoul, Korea.

4Department of Surgery, Bundang Seoul National University Hospital, Seongnam, Korea.

Corresponding author (kjparkmd@plaza.snu.ac.kr)

Received 7 September 2009       Accepted 5 October 2009

Copyright © 2010 The Korean Surgical Society

Abstract

Purpose

We performed this study to share experiences in the management of obturator hernia, which is a very rare disease among elderly women, because rarity of this disease will not approve an expert institute or surgeon and because the aging society, Korea, can increase the incidence.

Methods

Patient characteristics, clinical manifestations and treatment results were retrospectively collected from the 12 obturator hernia patients since 2000 in the three hospitals of the authors. Twenty-one obturator hernia cases reported in the Korean literatures were reviewed. In addition, we analyzed clinical features and treatment results of the total 33 patients, collectively.

Results

Most of the patients were elderly women except one young, poorly nourished, male patient with pulmonary tuberculosis. Their mean age was 79.6 years. Sixty-four percent (21/33) of the patients had preoperative morbidity. Symptoms from the compression of the obturator nerve, which is an important clue to the diagnosis, were observed in 67% (22/33). Interestingly, spontaneous or suspicious-spontaneous reductions were reported in 7 (21%) patients. Abdominal CT scan was the major tool for diagnosis. Abdominal approach alone could successfully manage most cases, though 84% (27/32) needed anastomosis of the bowel. Operative mortality was 2 of the 32 cases but morbidity was 44% of the 32 patients and the mean hospital period after operation was 21 days.

Conclusion

Management of patients with obturator hernJd surgical management and proper peri-operative care as well as appropriate managing the families is essential for improved results.

Keywords: Obturator hernia, Mortality, Morbidity

Figures and Tables

Fig. 1
Abdominal CT scan of obturator hernia. (A) Small bowel segment heniates through left obturator canal. (B) Herniated bowel is incarcerated between pectineus and external obturator muscle.
jkss-78-41-g001
Fig. 2
Operative findings of strangulated hernia. (A) Small bowel is herniated and incarcerated through obturator canal. (B) Strangulated bowel segment is reduced and torn. (C) Hernia sac is inverted for repair.
jkss-78-41-g002
Table 1
Patient characteristics and treatment results
jkss-78-41-i001

*abd. = abdominal; †H-R sign = Howship-Romberg sign; ‡If there was no delay in diagnosis and treatment it was estimated as one day; §ER = hospitalization via emergency room; ∥HT = hypertension; P = femoral area pain; **COPD = chronic obstructive pulmonary disease; ††This patient is reported in J Korean Surg Soc 2009;77:211-5 (Ref. 7); ‡‡Cholecystec. = cholecystectomy; §§S = H-R sign; ∥∥MR = mitral regurgitation; Appendec. = appendectomy; ***CVA = cardiovascular accident; †††DM = diabetes mellitus.

Table 2
Obturator hernia cases reported in Journal of the Korean Surgical Society
jkss-78-41-i002

*abd. = abdominal; †H-R sign = Howship-Romberg sign; ‡If there was no delay in diagnosis and treatment it was estimated as one day; §ER = hospitalization via emergency room; ∥S = H-R sign; HT = hypertension; **P = femoral area pain; ††M = femoral area mass; ‡‡Appendec. = appendectomy; §§DM = diabetes mellitus; ∥∥COPD = chronic obstructive pulmonary disease.

Table 3
Clinical characteristics of total 33 obturator hernia patients reported in Korea
jkss-78-41-i003

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