A HERNIA YOU DONT PALPATE: CT DIAGNOSIS OF OBTURATOR HERNIA

Background: Obturator hernia is an uncommon type of pelvic hernia but carries the highest mortality among abdominal wall hernias, largely due to delayed diagnosis. Clinical presentation is often nonspecific, and both clinical examination and imaging may pose diagnostic challenges. Early recognition and surgical intervention are crucial for improving outcomes.

Materials and Methods: We report the case of a 59-year-old woman who presented with intermittent features of small bowel obstruction accompanied by right medial thigh pain. Physical examination revealed no palpable hernia at the usual hernial orifices. Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis was performed as part of the radiologic evaluation.

Results: CT imaging suggested aright incarcerated obturator hernia as the likely cause of bowel obstructionwith the herniated bowel segment passing through the obturator foramen and lying within the obturator canal between the pectineus and obturator muscles.