Skip to main content
Erschienen in: World Journal of Surgery 4/2005

01.04.2005 | Original Scientific Report

A Review of Obturator Hernia and a Proposed Algorithm for its Diagnosis and Treatment

verfasst von: Shen-Shin Chang, M.D., Yan-Shen Shan, M.D., Yih-Jyh Lin, M.D., Yun-Sheng Tai, M.D., Pin-Wen Lin, M.D.

Erschienen in: World Journal of Surgery | Ausgabe 4/2005

Einloggen, um Zugang zu erhalten

Abstract

The aim of this article is to provide a review of six patients with the various stages of obturator hernia and a diagnostic and therapeutic strategy in suspected cases. Obturator hernia is relatively rare and is a diagnostic challenge. It is a significant cause of intestinal obstruction, especially in emaciated elderly women with chronic disease. A palpable groin mass is not common in these patients because the hernia mass is usually concealed beneath the pectineus muscle. The high mortality is directly related to the delayed recognition, with resultant ruptured gangrenous bowel, and to the high incidence of patients with concurrent medical illness. A total of six patients with obturator hernias were treated at this hospital between 1994 and 2004, and one of these patients was diagnosed and treated by elective laparoscopy. We reviewed these six cases and examined the clinical presentation, age, body weight, associated medical conditions, preoperative diagnosis, operative findings, complications, and outcome in this retrospective study. We concluded that we cannot shorten the time from onset of symptoms to admission, but what we can do is to make a rapid evaluation and surgical intervention to reduce the morbidity and mortality from obturator hernia. The approaches to different presentation of obturator hernia and diagnostic role of CT scan are also discussed.
Literatur
1.
Zurück zum Zitat Ziegler, DW, Rhoads, JE. 1995Obturator hernia needs a laparotomy, not a diagnosisAm. J. Surg.1706768CrossRefPubMed Ziegler, DW, Rhoads, JE. 1995Obturator hernia needs a laparotomy, not a diagnosisAm. J. Surg.1706768CrossRefPubMed
2.
Zurück zum Zitat Jorge, CG, Manuel, RD, Alexandro, ED, et al. 1998Incarcerated obturator hernia successfully treated by laparoscopySurg. Laparosc. Endosc.87173CrossRefPubMed Jorge, CG, Manuel, RD, Alexandro, ED,  et al. 1998Incarcerated obturator hernia successfully treated by laparoscopySurg. Laparosc. Endosc.87173CrossRefPubMed
3.
Zurück zum Zitat Ijiri, R, Kanamaru, H, Yokoyama, H, et al. 1996Obturator hernia: the usefulness of computed tomography in diagnosisSurgery119137140PubMed Ijiri, R, Kanamaru, H, Yokoyama, H,  et al. 1996Obturator hernia: the usefulness of computed tomography in diagnosisSurgery119137140PubMed
4.
Zurück zum Zitat Gray, SW, Skandalakis, JE, Soria, RE, et al. 1974Strangulated obturator herniaSurgery752027PubMed Gray, SW, Skandalakis, JE, Soria, RE,  et al. 1974Strangulated obturator herniaSurgery752027PubMed
5.
Zurück zum Zitat Nishina, M, Fujii, C, Ogino, R, et al. 2001Preoperative diagnosis of obturator hernia by computed tomography in six patientsJ. Emerg. Med.20277280CrossRefPubMed Nishina, M, Fujii, C, Ogino, R,  et al. 2001Preoperative diagnosis of obturator hernia by computed tomography in six patientsJ. Emerg. Med.20277280CrossRefPubMed
6.
Zurück zum Zitat Terada, R, Ito, S, Kidogawa, H, et al. 1999Obturator hernia: the usefulness of emergent computed tomography for early diagnosisJ. Emerg. Med.17883886CrossRefPubMed Terada, R, Ito, S, Kidogawa, H,  et al. 1999Obturator hernia: the usefulness of emergent computed tomography for early diagnosisJ. Emerg. Med.17883886CrossRefPubMed
7.
Zurück zum Zitat Bergstein, JM, Condon, RE. 1996Obturator hernia: current diagnosis and treatmentSurgery119133136PubMed Bergstein, JM, Condon, RE. 1996Obturator hernia: current diagnosis and treatmentSurgery119133136PubMed
8.
Zurück zum Zitat Gunnar, A. 1984Strangulated obturator herniaActa Chir. Scand.150337339PubMed Gunnar, A. 1984Strangulated obturator herniaActa Chir. Scand.150337339PubMed
9.
Zurück zum Zitat Chang, SS, Tai, YS, Lin, PW. 2003Obturator hernia diagnosed and treated by laparoscopy: a case reportFormosa. J. Surg.36244247 Chang, SS, Tai, YS, Lin, PW. 2003Obturator hernia diagnosed and treated by laparoscopy: a case reportFormosa. J. Surg.36244247
10.
Zurück zum Zitat Rogers, FA 1964Strangulated obturatorNyhus, LMHarkins, JN eds. HerniaLippincottPhiladelphia637644 Rogers, FA 1964Strangulated obturatorNyhus, LMHarkins, JN eds. HerniaLippincottPhiladelphia637644
11.
Zurück zum Zitat Bjork, KJ, Mucha, P, Cahill, DR. 1988Obturator herniaSurg. Gynecol. Obstet.167217222PubMed Bjork, KJ, Mucha, P, Cahill, DR. 1988Obturator herniaSurg. Gynecol. Obstet.167217222PubMed
12.
Zurück zum Zitat Skandalakis, LJ, Androulakis, J, Colborn, GL, et al. 2000Obturator hernia. Embryology, anatomy, and surgical applicationsSurg. Clin. North Am.807184CrossRefPubMed Skandalakis, LJ, Androulakis, J, Colborn, GL,  et al. 2000Obturator hernia. Embryology, anatomy, and surgical applicationsSurg. Clin. North Am.807184CrossRefPubMed
13.
Zurück zum Zitat Callaghan, CJ, Whitaker, RH. 2002Obturator canal fat plug: a pre-hernia condition?Clin Anat15276279CrossRefPubMed Callaghan, CJ, Whitaker, RH. 2002Obturator canal fat plug: a pre-hernia condition?Clin Anat15276279CrossRefPubMed
14.
Zurück zum Zitat Yip, AW, AhChong, AK, Lam, KH 1993Obturator hernia: a continuing diagnostic challengeSurgery113266269PubMed Yip, AW, AhChong, AK, Lam, KH 1993Obturator hernia: a continuing diagnostic challengeSurgery113266269PubMed
15.
Zurück zum Zitat Gray, SW, Skandalakis, JE, Soria, RE, et al. 1974Strangulated obturator herniaSurgery752027PubMed Gray, SW, Skandalakis, JE, Soria, RE,  et al. 1974Strangulated obturator herniaSurgery752027PubMed
16.
Zurück zum Zitat Rogers, FA. 1960Strangulated obturator herniaSurgery48394403PubMed Rogers, FA. 1960Strangulated obturator herniaSurgery48394403PubMed
17.
Zurück zum Zitat Yokoyama, T, Munakata, Y, Ogiwara, M, et al. 1997Preoperative diagnosis of strangulated obturator hernia using ultrasonographyAm. J. Surg.1747678CrossRefPubMed Yokoyama, T, Munakata, Y, Ogiwara, M,  et al. 1997Preoperative diagnosis of strangulated obturator hernia using ultrasonographyAm. J. Surg.1747678CrossRefPubMed
18.
Zurück zum Zitat Kanzaki, H, Kameoka, S, Imai, S, et al. 1989Three cases of obturator hernia diagnosed preoperatively by ultrasonography. Nippon Rinsho Geka Igakkai ZasshiJ. Jpn. Soc. Clin. Surg.5024882499 Kanzaki, H, Kameoka, S, Imai, S,  et al. 1989Three cases of obturator hernia diagnosed preoperatively by ultrasonography. Nippon Rinsho Geka Igakkai ZasshiJ. Jpn. Soc. Clin. Surg.5024882499
19.
Zurück zum Zitat Gullmo, A. 1980Herniography: the diagnosis of hernia in the groin and incompetence of the pouch of Douglas and pelvic floorActa Radiol. Suppl.36171 Gullmo, A. 1980Herniography: the diagnosis of hernia in the groin and incompetence of the pouch of Douglas and pelvic floorActa Radiol. Suppl.36171
20.
Zurück zum Zitat Yokoyama, Y, Yamaguchi, A, Isogai, M, et al. 1999Thirty-six cases of obturator hernia; does computed tomography contribute to postoperative outcome? World JSurg.23214216 Yokoyama, Y, Yamaguchi, A, Isogai, M,  et al. 1999Thirty-six cases of obturator hernia; does computed tomography contribute to postoperative outcome? World JSurg.23214216
21.
Zurück zum Zitat Schmidt, PH, Bull, WJ, Jeffery, KM, et al. 2001Typical versus atypical presentation of obturator herniaAm. Surg.67191195PubMed Schmidt, PH, Bull, WJ, Jeffery, KM,  et al. 2001Typical versus atypical presentation of obturator herniaAm. Surg.67191195PubMed
22.
Zurück zum Zitat Sinha, SN, DeCosta, AE. 1983Obturator herniaAust. N. Z. J. Surg.53349351PubMed Sinha, SN, DeCosta, AE. 1983Obturator herniaAust. N. Z. J. Surg.53349351PubMed
23.
Zurück zum Zitat Hershman, MJ, Reilly, DT, Swift, RI. 1986Strangulated obturator hernia: delayed diagnosis is still the ruleJ. R. Coll. Surg. Edinb.31282283PubMed Hershman, MJ, Reilly, DT, Swift, RI. 1986Strangulated obturator hernia: delayed diagnosis is still the ruleJ. R. Coll. Surg. Edinb.31282283PubMed
24.
Zurück zum Zitat Cubillo, E. 1983Obutrator hernia diagnosed by computed tomographyAm. J. Roentgenol.140735736 Cubillo, E. 1983Obutrator hernia diagnosed by computed tomographyAm. J. Roentgenol.140735736
25.
Zurück zum Zitat Somell, A, Ljungdahl, I, Spangen, L. 1976Thigh neuralgia as a symptom of obturator herniaActa Chir. Scand.142457459PubMed Somell, A, Ljungdahl, I, Spangen, L. 1976Thigh neuralgia as a symptom of obturator herniaActa Chir. Scand.142457459PubMed
26.
Zurück zum Zitat Tucker, JG, Wilson, RA, Ramshaw, BJ, et al. 1995Laparoscopic herniorrhaphy: technical concerns in prevention of complications and early recurrenceAm. Surg.613639PubMed Tucker, JG, Wilson, RA, Ramshaw, BJ,  et al. 1995Laparoscopic herniorrhaphy: technical concerns in prevention of complications and early recurrenceAm. Surg.613639PubMed
27.
Zurück zum Zitat Miki, Y, Sumimura, J, Hasegawa, T, et al. 1998A new technique of laparoscopic obturator hernia repair: report of a caseSurg. Today28652656CrossRefPubMed Miki, Y, Sumimura, J, Hasegawa, T,  et al. 1998A new technique of laparoscopic obturator hernia repair: report of a caseSurg. Today28652656CrossRefPubMed
Metadaten
Titel
A Review of Obturator Hernia and a Proposed Algorithm for its Diagnosis and Treatment
verfasst von
Shen-Shin Chang, M.D.
Yan-Shen Shan, M.D.
Yih-Jyh Lin, M.D.
Yun-Sheng Tai, M.D.
Pin-Wen Lin, M.D.
Publikationsdatum
01.04.2005
Erschienen in
World Journal of Surgery / Ausgabe 4/2005
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-004-7664-1

Weitere Artikel der Ausgabe 4/2005

World Journal of Surgery 4/2005 Zur Ausgabe

Original Scientific Report

Invited Commentary

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.