Obstrucción intestinal por hernia obturatriz. Caso clínico*. Drs. MARCELO FONSECA C.1,3, CEDRIC ADELSDORFER O.1,3, MILENKO SLAKO M.1,3,. PEDRO. La hernia obturatriz es una rara causa de obstrucción intestinal, se presenta en pacientes mujeres adultos mayores, desnutridos y postrados;. Request PDF on ResearchGate | On Jan 1, , E. Soto-Pérez-de-Celis and others published Hernia obturatriz, una causa poco común de obstrucción.
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We present the case of an 87 hernja old woman with a history of ischemic heart disease, hypothyrodism and chronic obstructive pulmonary disease. She presented to our emergency department with abdominal pain located in the left iliac fossa, radiating to the thigh and accompanied by nausea and constipation. Due to its rarity and high mortality, every clinician facing patients with intestinal obstruction should consider it as a differential diagnosis.
Ann Acad Med Singapore. One of such causes is obturator hernia, which usually occurs in elderly women and is very easily to detect without imaging studies.
The patient was moved to a hospital ward, where she had an uneventful recovery, and she was discharged home. Due to the lack of improvement, an obturatirz tomography was performed, showing a hernia of the obturator canal filled with intestinal loops Figure 1. This hernia consists of a protrusion of the intestine through the obturator foramen in the pelvic floor.
Another classic sign is the Hannington-Kiff sign, characterized by the absence of the adductor reflex which is elicited by tapping on the adductor muscle 5 centimeters above the knee 3. The pain experienced by our patient, originating from the lower abdomen and radiating to the anterior thigh, is usual in this entity. Physical examination revealed abdominal distension, tympanism and absence of peristaltic movements.
At the same time, this case illustrates the importance of abdominal tomography in select patients presenting to the emergency room with the acute abdomen or intestinal obstruction. Obturator hernia, an uncommon cause of intestinal obstruction. Obturator hernia in an ageing society.
Plain abdominal films showed dilated loops of small bowel with air fluid levels and absence of distal air. In the elderly, intestinal obstruction carries a high mortality and its causes are different from those found in younger individuals.
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Obturator hernia should always be considered as a differential diagnosis in elderly women with intestinal obstruction, and a thorough physical examination directed towards this entity should be performed. Obturator hernia, also known as the “skinny old lady hernia” is usually found among septuagenarian women 1.
Case presentation We obhuratriz the case of an 87 year old woman with a history of ischemic heart disease, hypothyrodism and chronic obstructive pulmonary disease. Once the defect is identified, it should be repaired urgently via an open or laparoscopic approach 2. Abdominal computed tomography is the imaging study of choice for the diagnosis of obturator hernia 4. J Am Coll Surg.
No complications were reported and there was no evidence of intestinal ischemia. In women this foramen is wider, and because of that this hernia is more frequent in female patients.
Hernia obturatriz, una causa poco común de obstrucción intestinal
Intestinal obstruction is one of the most common diseases worldwide. The most characteristic sign is the Howship-Romberg sign, which consists in a worsening of the pain with the extension, adduction and internal rotation of the extremity due to the compression of the obturator nerve 1.
A body mass index below Discussion Obturator hernia, also known as the “skinny old lady hernia” is usually found among septuagenarian women 1. Diagnosis and treatment of obturator hernia. The most common clinical presentation of obturator hernia is intestinal obstruction. This is due to the delay in diagnosis, the high incidence of intestinal ischemia and perforation, and the affected demographics.
The patient was operated by means of a medial incision with liberation of the ileum, sac dissection and placement of a mesh in the defect.
A nasogastric tube was inserted and intravenous fluids were administered without clinical improvement. The obturator foramen is located between the two ramus of the ischium and the pubis, and represents a 0.