Presentation
Nausea, vomiting, anorexia for a week. She has no operation history except c/s section.
Patient Data
Long segments of proximal small bowel dilatation can be seen. Also, air-fluid levels can be noted. These findings can be revealed as an ileus of the small intestine. The dilated small bowel can be follow up until the obturator hernia.
Please note a large hiatal hernia and dilated stomach.
Also, note the collaborated large bowel; which can be distinguished relatively easily because of a given rectal contrast.
Case Discussion
Obturator hernia is usually a subtle diagnosis for clinician although inguinal hernias are usually diagnosed easily by physical examination. CT usually makes the diagnosis succesfully 1. Females are more prone, especially women in their seventh or eighth decades, because of the wider pelvis, greater transverse diameter. Because of the range of age and gender predilection, this disease sometimes can be called “the skinny old lady hernia” 1. Obturator hernias constitute % 0.07-1 % of all hernias 2. Also, obturator hernia has the highest mortality rate (%13-40) in all of the abdominal hernias 3.
The radiologist must be aware of this condition because of the high mortality and subtle diagnosis of obturator hernia.
In this case, the clinician has no specific physical examination findings. Because of high clinical suspicion of ileus patients evaluated with computerized tomography. After the diagnosis of the obturator hernia, patient goes surgery which is the only treatment for obturator hernia.