大腿部膿ようへと進展した穿孔性閉鎖孔ヘルニアの１例

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  • A Case of Perforated Left Obturator Hernia with Femoral Abscess.

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Obturator hernia which is common in elderly women is relatively rare, and especially few cases of perforated obturator hernia have been reported so far. We present a case of left obturator hernia in which the incarcerated small intestine through the obturator hernia perforated, causing giant femoral abscess formation.<br> An 82-year-old woman complaining of vomiting and abdominal and left femoral pain was referred to the hospital with a diagnosis of ileus and femoral gas gangrene. Abdominal X-ray film showed left femoral gas shadow. CT scan showed abscess formation just below the obturator foramen to left femoral region. Enterococcus was detected from a punctured content of the left fermoral abscess. We diagnosed the case as incarcerated left obturator hernia with intestinal perforation to the left femoral region. Intraoperatively, perforation of the small intestine was detected at about 75cm oral side the terminal ileum, which was incarcerated into the left obturator foramen and formed abscess in the left femoral region. The ruptured intestine was resected, and the obturator foramen was closed using a broad ligament of the uterus. She improved and was discharged from the hospital 1.5 month after the operation.

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