回腸および卵巣が嵌頓した閉鎖孔ヘルニアの1例

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  • A CASE OF OBTURATOR HERNIA WHERE THE ILEUM AND OVARY WERE INCARCERATED

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Obturator hernia is a rare entity. In most cases the small intestine is involved. Recent experience with a case of obturator hernia in which the small intestine and right ovary were simultaneously incarcerated is reported.<br> An 88-year-old woman developed an abdominal pain and vomiting after a dinner and then felt a pain in the right thigh which gradually increased. The patient was emergently admitted to the hospital with a diagnosis of intestinal obstruction like symptoms based on a plain abdominal X-ray film. Howship-Romberg sign was noted and so ultrasonography (US) of the inguinal region and CT scan of the pelvic region were carried out. The patient was diagnosed as right obtulator hernia and was operated on emergently. During operation the ileum about 20cm from the ileocecal region and the right ovary were incarcerated into a righ obturator was confirmed. Incarceration of the ileum was Richeter type, and when it was reduced, the ileum was found to include a necrosed part. Partial excision of the ileum was carried out and the right ovary was repaired. Making the definite diagnosis of obturator hernia in this case, US of the inguinal region and CT scan of the pelvic region were valuable. In addition incarceration of the ovary was able to be retrospectively confirmed by US. Although it took only 24 hours from the onset of symptoms to operation in this case, the incarcerated intestine wa already necrosed. This fact means that this disease should be diagnosed as early as possible and laparotomy which permits us to observe the entrie intestine is recommended.

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