Acute incarcerated obturator hernia.

BACKGROUND

Obturator hernia is a rare cause of intestinal obstruction that can be challenging to diagnose due to unspecific clinical presentation.

CASE PRESENTATION: A woman in her eighties with a history of involuntary weight loss presented to the emergency department due to acute pain in her right thigh, nausea and vomiting. On examination, the patient exhibited tenderness to palpation in the proximal and medial aspect of her right thigh. Abdominal computed tomography revealed a loop of small bowel protruding through the right obturator canal, consistent with an incarcerated obturator hernia. An emergency laparoscopy was performed, revealing that the affected small bowel segment was viable after reduction of the hernia. Due to development of respiratory acidosis and hypotension, the obturator defect was primarily sutured to reduce operating time. The patient made a good recovery and was transferred to the medical ward for further evaluation of her weight loss.

INTERPRETATION: This case illustrates the diagnostic challenge associated with obturator hernias.