Mechanical intestinal obstruction in underweight, elderly women: obturator hernia

Obturator hernia is an infrequent pelvic hernia observed in elderly, emaciated and multiparous women. It often presents with nonspecific clinical symptoms, making it difficult to diagnose. We conducted a retrospective descriptive study on 11 patients admitted to our hospital for intestinal obstruction due to incarcerated obturator hernia from 2009 to 2020. Eight patients underwent laparotomy with low midline incision. Laparoscopic approach was tried on the other three patients with two patients converting to open surgery because of inadequate visualization, and only one patient received laparoscopic repair. Of the 10 patients receiving laparotomy, seven cases received hernia repair with a match and three cases were performed simple peritoneal closure following bowel resection. One patient died of multiple organ failure. Laparotomy with low midline incision is commonly used to manage obturator hernia in an emergency, whereas laproscopic approach may only apply to some selected cases.