Emergency management of obturator hernıa in elderly patients: A case series and surgical strategy.
Ender Bademkiran, Doguş Coskun, Ekin Ulusoy et al.
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Case in brief
Three elderly, cachectic women presented with symptoms and signs of mechanical intestinal obstruction. CT imaging identified obturator hernias, and all underwent emergency surgery. Depending on operative findings and patient condition, surgeons used laparoscopic transabdominal preperitoneal repair or open midline laparotomy. The obturator defects were closed with primary sutures rather than polypropylene mesh, given concerns including enteric contamination, bowel perforation, suspected ischemia, or frailty. The report describes successful management with this CT-supported diagnosis and individualized operative approach.
What made this case unusual
The surgical strategy avoided mesh and used primary suture repair in all three patients, with the choice informed by contamination, bowel compromise, or frailty-related concerns about delayed mesh complications.
Diagnostic / clinical pearl
In an elderly patient with mechanical bowel obstruction, maintain suspicion for obturator hernia despite nonspecific findings; CT can establish the diagnosis and assess bowel viability before emergency surgery.