Strangulated Obturator Hernia: A Case Report and Review of the Literature

An obturator hernia (OH) is a rare cause of small-bowel obstruction that predominantly affects elderly, frail, thin, and multiparous women.Its nonspecific clinical presentation can delay diagnosis and lead to bowel strangulation, necrosis, and perforation.We report the case of a 91-year-old woman who presented with a two-day history of vomiting, obstipation, and diffuse abdominal pain.Notably, four days before this admission, she had sought emergency care for lower-back pain radiating to the left lower limb.Computed tomography (CT) demonstrated an incarcerated left OH.Emergency laparotomy revealed ischemic and necrotic small bowel with perforation, requiring a segmental enterectomy.The hernia defect was repaired using a mesh plug, which was covered with peritoneum.Despite postoperative cardiopulmonary complications, she recovered and was discharged to a nursing home on postoperative day 13.An OH is a rare but life-threatening condition that demands a high index of clinical suspicion.Prompt CT imaging and early surgical intervention are essential to reduce morbidity and mortality associated with intestinal strangulation.This case highlights the importance of considering OHs in elderly women presenting with unexplained lower-limb pain, which may precede the onset of bowel obstruction.It also suggests that mesh repair may be considered in carefully selected patients requiring bowel resection when contamination is limited.