scholarly journals Bowel obstruction in obturator hernia: a challenging diagnosis

2021 ◽  
Vol 8 (7) ◽  
pp. 2212
Author(s):  
Nimisha Ramachandran Chemmangattuvalappil ◽  
Babu John Pulluvelil ◽  
Ravindran Chirukandath ◽  
Santosh Vijayan Thekoot ◽  
Bobby Sebastian
Keyword(s):  
Bowel Obstruction ◽  
Clinical Case ◽  
Surgical Intervention ◽  
Exploratory Laparotomy ◽  
Obturator Hernia ◽  
Rare Type ◽  
Obturator Foramen ◽  
Surgical Interventions ◽  
Emergency Surgical Intervention ◽  
Specific Symptoms

The obturator hernia is a rare pelvic hernia that presents as bowel obstruction caused by the presence of an intestinal segment, more often ileum passing through obturator foramen. This type of hernia accounts for 0.5-1.4% of all hernias. We reported the clinical case of a 74 year old woman with no previous surgical interventions, presented to ER with abdominal pain and distension, features of intestinal obstruction, which she had experienced for previous three days. A CT scan revealed a right jejunal, obstructed obturator hernia. The patient underwent an emergency surgical intervention with emergency exploratory laparotomy and repair. This case was presented as obturator hernia was a rare type of hernia due to its diagnosis, which is often unclear with non-specific pain radiating to legs mimicking neurological symptoms. A prompt suspect based for the non-specific symptoms is crucial for the diagnosis. Surgical management depends on early diagnosis and it is the only possible treatment for this pathology.

scholarly journals Small bowel obstruction secondary to obturator hernia in an elderly female

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Aneela Devarakonda ◽  
Aarav Gupta-Kaistha ◽  
Nikhil Kulkarni
Keyword(s):  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Delayed Diagnosis ◽  
Obturator Hernia ◽  
Computed Tomography Imaging ◽  
Rare Type ◽  
Midline Laparotomy ◽  
Mortality And Morbidity ◽  
Tomography Imaging ◽  
High Index Of Suspicion

Abstract Obturator hernia is an extremely rare type of pelvic hernia with relatively high mortality and morbidity due to delayed diagnosis. Most cases present with acute intestinal obstruction and typically affect elderly, emaciated females. A high index of suspicion is required for early diagnosis and timely surgical intervention. We present a rare case of an 81-year-old female who was initially discharged from the emergency department due to nonspecific symptoms. She represented with clinical features of bowel obstruction and was diagnosed preoperatively with computed tomography imaging identifying a left-sided obturator hernia with a loop of bowel extending through the obturator canal. She was taken to theater for lower midline laparotomy and repair of obturator hernia. Although many cases are identified intraoperatively, we will discuss preoperative means of diagnosis of obturator hernia from examination findings to imaging diagnosis.

scholarly journals Obstructed obturator hernia containing Meckel’s diverticulum: a case report

2018 ◽  
Vol 6 (1) ◽  
pp. 317 ◽  
Author(s):  
Sharad Jain ◽  
Motilal Maida ◽  
Sagar Manohar Patil
Keyword(s):  
Meckel’S Diverticulum ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
Obturator Hernia ◽  
Mri Scan ◽  
Rare Type ◽  
Obturator Foramen ◽  
Polypropylene Sutures ◽  
Ct And Mri

An obturator hernia is a rare type of hernia and unusual cause of acute intestinal obstruction. The combination of diagnostic difficulty and high mortality rates make obturator hernia a serious diagnosis that can be potentially overlooked. We present a case of an elderly multiparous woman presented at the emergency room with complaints of abdominal distension, pain, vomiting and constipation for the last 4 days. On examination abdominal tenderness with distension was noted. Hernial orifices were normal. A CT and MRI reports were suggestive of right obstructed obturator hernia. Patient underwent emergency exploratory laparotomy. The hernial sac contained a narrow neck Meckel's diverticulum with perforation of proximal ileum. Resection of perforated segment along with Meckel's diverticulum was done and end to end ileo-ileal anastomosis was performed. Obturator foramen was closed with simple polypropylene sutures. CT/MRI scan is of immense help in preoperative diagnosis. Once the diagnosis is suspected or confirmed, patient should be taken for surgery as early as possible.

scholarly journals Richter's type of obturator hernia with Howship Romberg sign: a case report

2021 ◽  
Vol 8 (12) ◽  
pp. 3738
Author(s):  
S. P. Gayathre ◽  
M. Kudiyarasu ◽  
Bala Brindha Saugunan ◽  
R. Kannan
Keyword(s):  
Primary Closure ◽  
Clinical Signs ◽  
Acute Intestinal Obstruction ◽  
Obturator Hernia ◽  
Emergency Laparotomy ◽  
Diagnostic Challenge ◽  
Rare Type ◽  
Obturator Foramen ◽  
Abdominal Hernias ◽  
Specific Symptoms

Obturator hernia is a rare type of pelvic hernia in which intraperitoneal contents protrude through the obturator foramen and is most commonly found in females. It accounts for about 1% of all abdominal hernias and possesses a great diagnostic challenge due to the non-specific symptoms and meagre clinical signs. Hereby we report a case of obturator hernia in an nonagenarian emaciated fragile old lady who presented with features of acute Intestinal obstruction and was diagnosed using computed tomography as right sided obturator hernia and eventually was taken up for emergency laparotomy. The herniated segment was resected and anastomosis was done with primary closure of the defect. Postoperative period was uneventful and the patient was discharged on postoperative day 7. 

scholarly journals Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gastrointestinal Symptoms ◽  
Exploratory Laparotomy ◽  
Abdominal Adhesions ◽  
Abdominal Radiography ◽  
Foreign Body Removal ◽  
Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

scholarly journals SMALL BOWEL OBSTRUCTION SECONDARY TO OBTURATOR HERNIA: A PRE-OPERATIVE DIAGNOSIS AT COMPUTED TOMOGRAPHY

2021 ◽  
Vol 6 (1) ◽  
pp. 46-49
Author(s):  
Marlina Tanty Ramli ◽  
Mohd Shukry Mohd Khalid ◽  
Kartini Rahmat
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Obturator Hernia ◽  
Uneventful Recovery ◽  
Presenting Symptoms

Obturator hernia is rare, but it must be considered in elderly patients who present with small bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as the presenting symptoms and signs are usually non-specific. Presence of positive Howship-Romberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We report a case of a 93-year-old female patient who was admitted to our surgical department with symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative. Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy post-CT where the incarcerated bowel loop was released and the obstructed bowel was decompressed without any complication. The hernial defect was close with a mesh and the patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of obturator hernia must always be considered in elderly patients who present with intestinal obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids inappropriate surgical intervention planning which is crucial in optimising the outcome.

Su2069 ELECTIVE VS UNPLANNED SURGICAL INTERVENTIONS FOR BOWEL OBSTRUCTION IN CROHN'S DISEASE: IS THERE A ROLE FOR PREEMPTIVE SURGICAL INTERVENTION?

2020 ◽  
Vol 158 (6) ◽  
pp. S-1570
Author(s):  
David Koller ◽  
Kenneth D. Allen ◽  
Sean Maroney ◽  
Alan Harzman ◽  
mark arnold ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Surgical Interventions

scholarly journals Validation of peritoneal adhesion index as a standardized classification to universalize peritoneal adhesions definition

2017 ◽  
Author(s):  
Paola Fugazzola ◽  
Federico Coccolini ◽  
Gabriela E. Nita ◽  
Giulia Montori ◽  
Davide Corbella ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Roc Curve ◽  
Surgical Intervention ◽  
Multicenter Trial ◽  
Previous Surgery ◽  
Peritoneal Adhesion ◽  
Peritoneal Adhesions ◽  
Surgical Interventions ◽  
Definition Of ◽  
Adhesion Index

Peritoneal adhesion index (PAI) is a score based on appearance and distribution of peritoneal adhesions. The study aims to assess the validity of PAI in order to standardize the definition of peritoneal adhesions. The study includes an expert survey to assess the feasibility of the score and a prospective observational and multicenter trial to assess its validity. 96% of surgeons of the survey consider PAI a useful tool. From January 2013 to March 2015, 205 patients were enrolled to undergo a surgical intervention for bowel obstruction caused by peritoneal adhesions in 21 centers. PAI was significantly higher in the population with previous surgery (P=0.043) and in patients who underwent two previous surgical interventions, if compared to those with only one previous intervention (P=0.012). Length of surgery was significantly longer in patients with higher PAI (P<0.001). Patients with a higher PAI showed a clinically higher risk for early bowel re-obstruction and for early re-intervention. The AUC of the ROC curve for early re-occlusion is 0.8. PAI can be considered a feasible and useful score.

scholarly journals RARE-03. CNS GERMINOMA WITH SYNCHRONOUS LESIONS IN THE SELLAR AND PINEAL REGIONS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi221-vi222
Author(s):  
Armen Simonyan ◽  
Anna Mikhaylova ◽  
Levan Lepsveridze ◽  
Maksim Semenov
Keyword(s):  
Clinical Case ◽  
Surgical Intervention ◽  
Symptomatic Treatment ◽  
Tumor Biopsy ◽  
Histological Changes ◽  
Difficult Situation ◽  
Surgical Interventions ◽  
Lack Of Information ◽  
Occlusive Hydrocephalus ◽  
Cns Malignancies

Abstract Germinomas comprise approximately 2–5% of all CNS malignancies, and have a favourable prognosis. Bad outcomes are relatively rare. Synchronous lesions occurs in 5–10% of cases. We report a case of 28 years old male, presented with motor aphasia, visual impairment and dysphagia. In period of last 15 months patient underwent 3 surgical interventions due to occlusive hydrocephalus. MRI revealed volume formations of the pineal and sellar regions. Taking into account the severity of the patient’s condition, consilium decided to refrain from surgical intervention and adjuvant therapy. Patient was transferred to the palliative unit. He died after 3 months. According to the results of the autopsy, the histological changes in tumors of the pineal and infundibular regions, corresponds to the germinoma. Due to the lack of information about patient’s treatment, carried out until hospitalization in our center, we don’t undertake to judge whether there was diagnostic omission, or incorrect treatment in this clinical case. But in our opinion, in case of suspected CNS germinoma, it is necessary to conduct more “aggressive treatment” (Tumor biopsy, followed by radiotherapy and chemotherapy). Symptomatic treatment should be used in cases, where the treatment of main disease is impossible. We hope that this sad clinical case will help Neurosurgeons in making decisions in a difficult situation.

scholarly journals Clinical Case of a Patient with Small Bowel Obstruction and Multiple Diospirobesoaras of the Gastrointestinal Tract

2020 ◽  
Vol 9 (2) ◽  
pp. 281-291
Author(s):  
A. S. Harutyunyan ◽  
V. D. Levitsky ◽  
V. V. Kiselev ◽  
P. A. Yartsev ◽  
A. V. Vodyasov ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Pseudomembranous Colitis ◽  
Clinical Case ◽  
Psychiatric Diseases ◽  
Surgical Interventions ◽  
Leading Role ◽  
Abdominal Organs ◽  
Acute Small Bowel Obstruction

Abstract Small bowel obstruction (SBO) is 3-4% of all abdominal acute diseases. Small bowel obstruction due to bezoars is rare (2-4%), and is detected mainly in patients with predisposing risk factors: gastrointestinal motility disorders, psychiatric diseases, enzymatic insufficiency, previous bariatric surgery, diabetes mellitus and hypothyroidism complicated by gastroparesis. The leading role in the verification of small bowel obstruction in patients without surgical interventions on the abdominal organs should be given to computed tomography. According to the literature, the mortality from SBO due to bezoar may reach 30%. We present an unusual clinical case of recurrent small bowel obstruction with severe intestinal disease and septic shock induced by multiple phytobezoars and complicated with severe pseudomembranous colitis. Moreover, in our opinion, laparoscopic access can be used both for diagnostic and therapeutic purposes in patients with acute small bowel obstruction.

scholarly journals Obturator hernia: case report

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Esubalew Taddese Mindaye ◽  
Dereje Giduma ◽  
Tesfaye H Tufa
Keyword(s):  
Abdominal Wall Hernia ◽  
Signs And Symptoms ◽  
Postoperative Recovery ◽  
Obturator Hernia ◽  
Delayed Presentation ◽  
Diagnostic Challenge ◽  
Rare Type ◽  
Obturator Foramen ◽  
Abdominal Content ◽  
Crampy Abdominal Pain

Abstract Obturator hernia, protrusion of abdominal content through the obturator foramen, is a rare type of abdominal wall hernia. Late patient presentation is associated with significant morbidity and mortality. We present rare case of obturator hernia causing small bowel obstruction in a 65-year-old-female patient. She presented with crampy abdominal pain, nausea and vomiting of three days duration. She was diagnosed with acute surgical abdomen and managed surgically at Arsi University College of health sciences, Assela, Ethiopia. Intraoperative finding revealed left-side obturator hernia, which is an extremely rare occurrence. Despite delayed presentation, our patient had smooth postoperative recovery. Obturator hernia is exceedingly rare, and it poses a diagnostic challenge as signs and symptoms are often nonspecific, making a preoperative diagnosis difficult. So, it should be considered as differential diagnosis in elderly patients presenting with acute surgical abdomen.

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