PREOPERATIVE DIAGNOSIS OF OBTURATOR HERNIA-REPORT OF TWO CASES

Obturator hernia, first reported by Ronsil in 1724, is a relatively rare disease. Recent experience with 2 cases of this disease which were definitely diagnosed before surgery is described. Case 1: A 77-year-old woman was referred to the hospital, because she was suspected having an obstruction of the ileum at other hospital. There was a 3-year history of suffering from abdominal pain, vomiting, and right medial femoral pain which were not treated. On admission to the hospital. Howship Romberg sign and ileogram indicated obturator hernia. Laparotomy was performed and it revealed an incarcerated ileum into the right obturator foramen about 1m from the end of ileum. The ileum by about 6cm was resected. Case 2: A 76-year-old woman was admitted to the hospital because of poor appetite, nausea, vomiting, and abdominal distension. Various examination indicated obstruction of the ileum due to obturator hernia. Abdominal CT revealed the incarcerated intestine, 22mm in diameter, between the obturator and pectineal muscles. Laparotomy was carried out and it was found that the ileum incarcerated into the left obturator foramen 60cm from the ileum end, causing ileus. After treeing of the ileus was performed, the hernia hilum was closed with direct suture. Postoperative course was uneventful in both cases. Prompt image studies are helpful for the early diagnosis of obturator bernia in old thin women.