Search

Hernias of the obturator foramen are rare. They are described mostly in elderly female patients in poor health. Often the correct diagnosis is stumbled upon as a result of surprising intraoperative findings. Surgical therapy is indicated often by the clinical symptoms of an incarcerated hernia. Herniation of the entire urinary bladder with hemorrhagic infarction has never been described before. For an anatomical reduction of the hernia it was necessary to resect the superior pubic ramus. For plastic reconstruction a marlex mesh was used.

In addition to the obturator nerve and vessels a fat body in the obturator canal is found in the majority of cases investigated. The fat body, small and isolated in newborns, is part of the subperitoneal mass of fat and loose areolar tissue in adults. In the 2 cases of obturator hernia the fat body has no connection with the peritoneum which constitutes the sac of the hernia. A strong fibrous cord running from the urinary bladder to the fat body of the obturator canal is observed in 46 cases. In 5 of these the cord causes a small pouch in the wall of the bladder.