Abstract
Background
Obturator hernias are uncommon but are important causes of intestinal obstruction. Delayed treatment can be fatal. Emergency surgery is considered the most effective treatment; however, patients with obturator hernia usually have comorbidities, and this precludes them from emergency surgery. Previously, a few case studies reported successful manual reductions for an incarcerated obturator hernia. However, their efficacy was not statistically confirmed. We have devised a new manual reduction method for an incarcerated obturator hernia based on previous studies. We have named this method “Four-hand Reduction for Obturator hernia with the Guidance of Sonography” (FROGS). This study aimed to evaluate the effectiveness of FROGS as a new treatment strategy for obturator hernia.
Methods
Since November 2019, we have tried FROGS in all patients with obturator hernia at the emergency room. We retrospectively compared the clinical data of 14 patients who underwent FROGS (after-FROGS group) with those of 23 patients who did not (before-FROGS group).
Results
All patients were females. There were no significant differences in age, lesion side, duration of symptoms, the diameter of the prolapsed bowel, and predisposing factors. The body mass index was significantly lower in the after-FROGS group than in the before-FROGS group. Manual reduction was successfully performed in all 14 patients in the FROGS group, whereas in the before-FROGS group, 14 patients underwent manual reduction, of whom only one was successfully treated using the non-FROGS method. Bowel resection was avoided in all 14 patients in the after-FROGS group, whereas 8 patients underwent bowel resection in the before-FROGS group. There were no significant differences in postoperative complications and mortality within 30 days after hernia presentation between the two groups.
Conclusion
Manual reduction using the FROGS technique was found to be safe and reproducible and can be the first treatment choice for patients with obturator hernia.
NON-INVASIVE MANUAL REDUCTION FOR INCARCERATED OBTURATOR HERNIA-REPORT OF FIVE CASES-
