Rare case of bilateral incarcerated obturator hernia: a case report

Here, we report the case of an 84-year-old woman with acute mechanical intestinal obstruction (AMIO) who was admitted to our Emergency Department. Computed tomography (CT) scan revealed an incarcerated bilateral obturator hernia, and the defect was resolved using transabdominal preperitoneal (TAPP) technique with polypropylene mesh. The patient was administered an oral regimen two days after the operation. The patient stayed in the intensive care unit for 4 days and was uneventfully discharged on the 9th postoperative day. Follow-up was scheduled at the 6th month, during which no adverse events were detected and the patient did not report any complaints. Obturator hernia is among the differential diagnoses of intestinal obstruction requiring early diagnosis and prompt surgical intervention. Laparoscopic approach is less invasive compared with open surgery, and it can be attempted in cases presenting with no sign of ischemia or peritonitis. TAPP technique should be preferred since it allows the control of all intraabdominal pathologies and the viability of the intestines.

Nadir görülen inkarsere iki taraflý obturator herni: Olgu sunumu

Acil cerrahi kliniðimize akut mekanik intestinal obstrüksiyon semptomlarý ile baþvuran 84 yaþýnda kadýn hasta sunuldu. Bilgisayarlý tomografi görüntülemesinde iki taraflý inkarsere obturator herni saptandý. Defektler poliprolen yama kullanýlarak Trans Abdominal Pre Peritoneal (TAPP) tekniði uygulanarak tamir edildi. Hasta ameliyat sonrasý dört gün boyunca yoðun bakým ünitesinde takip edildi, dokuzuncu gün sorunsuz taburcu edildi. Altýncý ay kontrollerinde herhangi bir sorunla karþýlaþýlmadý. Obturator herni, intestinal obstrüksiyonun ayýrýcý tanýsýnda düþünülmesi gereken, erken taný ve uygun cerrahi tedavi gerektiren bir kliniktir. Laparoskopik yaklaþým, açýk yaklaþýma göre daha az invaziv olup, iskemi ve peritonit bulgusu olmayan olgularda denenebilir. Bu hastalarda TAPP tekniði, tüm intraabdominal patololerin deðerlendirilmesi ve baðýrsaklarýn görüntülenebilmesi nedeniyle tercih edilmelidir.