Case Report: Marfan syndrome complicated with obturator hernia

Background: Obturator hernia is an extremely rare subtype of abdominal wall hernia, typically occurring in elderly female with a history of chronic increased intra-abdominal pressure or multiple pregnancies. However, it is rarely encountered in young individuals, which may lead to diagnostic oversight. Here, we report a case of a young female with Marfan syndrome who developed a left obturator hernia. Patient presentation: A young female with Marfan syndrome and pectus excavatum presented with 6 h of persistent severe left inguinal pain. Diagnostic process: Physical examination revealed a 2 cm × 2 cm localized swelling in the upper medial aspect of the left thigh, medial to the inguinal ligament. Left Howship-Romberg sign (+). Computed tomography (CT) examination indicated pectus excavatum, cardiomegaly, and a left obturator hernia. Intervention: Based on these findings, laparoscopic preperitoneal inguinal hernia mesh repair was performed. Outcome: The patient was discharged on postoperative day 3 and followed up for 14 months. Recovery was uneventful with no complications. Conclusion: This case highlights the importance of differential diagnostic thinking for hernias in patients with connective tissue diseases.