ACUTE OBSTRUCTIVE ABDOMEN RESULTING FROM LEFT OBTURATOR FORAMEN HERNIA

CASE REPORT

Abstract

INTRODUCTION: Obturator foramen hernias are rare and have high morbidity and mortality due to delayed diagnosis. It is more frequent in women and its treatment is imminently surgical. CASE REPORT: Female patient, 74 years old, referred for evaluation by the general surgery team with colic-like left iliac fossa pain radiating to the medial face of the ipsilateral thigh with 14 days of evolution. Associated with the condition, he reported hyporexia, nausea, vomiting and evacuation failure for 13 days. He denied previous pathologies. The patient had a computed tomography (CT) scan of the abdomen with a diagnosis of left inguinal hernia. Physical examination of the left inguinal region incompatible with diagnosis. A new CT scan was performed with evidence of obturator foramen hernia. Patient submitted to exploratory laparotomy, observing non-viable jejunum segment insinuated in obturator foramen. Enterectomy with enteroanastomosis was performed. The patient had a good clinical evolution. DISCUSSION: The obturator foramen hernia is a rare entity whose main predisposing factors are female sex, advanced age, low BMI associated with factors that lead to increased intra-abdominal pressure. It is difficult to diagnose clinically, and is commonly performed during an exploratory laparotomy procedure due to an obstructive acute abdomen. Attention should always be paid to this etiology in cases of obstructive acute abdomen without a defined cause. Its early identification and treatment promotes a considerable reduction in the morbidity and mortality of this pathology.