Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 7, 2010; 16(1): 126-130
Published online Jan 7, 2010. doi: 10.3748/wjg.v16.i1.126
Ileum perforation due to delayed operation in obturator hernia: A case report and review of literatures
Hong Zhang, Jin-Chun Cong, Chun-Sheng Chen
Hong Zhang, Jin-Chun Cong, Chun-Sheng Chen, Department of Colorectal Tumor Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Zhang H designed and wrote the paper; Cong JC managed the patient and examined radiologic findings; Chen CS performed the operation and supervised the research.
Supported by The Grant of Education Department of Liaoning Province, 2009A719
Correspondence to: Dr. Chun-Sheng Chen, Professor, Department of Colorectal Tumor Surgery, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Heping District, Shenyang 110004, Liaoning Province, China.
Telephone: +86-24-96615-31411 Fax: +86-24-83955072
Received: November 4, 2009
Revised: November 23, 2009
Accepted: November 30, 2009
Published online: January 7, 2010

A 83-year-old woman was admitted to our hospital because of intermittent abdominal colicky pain and vomiting for 26 h. The pain localized over the periumbilical area with radiation along the medial side of the thigh. Computed tomography scan with three-dimensional reconstruction revealed a loop of small bowel protruding into the left obturator canal. Incarcerated obturator hernia was diagnosed and emergency laparotomy was arranged immediately. Unfortunately, her family refused surgery because of her worsening condition. On the third evening after admission, the patient developed peritonitis and sepsis. Perforation of small bowel due to the incarceration was noted during laparotomy. Bowel resection and an end-ileostomy were performed. She recovered well despite of the complication of multiple organ dysfunction syndrome. Literature is reviewed, and the pathogenesis, clinical manifestation, imaging features and treatment are discussed.

Keywords: Obturator hernia, Intestinal obstruction, Computed tomography