A Masquerading and Unconventional Cause of Dynamic Intestinal Obstruction: Strangulated Obturator Hernia

Obturator hernia is an extremely rare type of abdominal wall hernia occurring mostly in elderly, thin females. It is characterized by the herniation of intra-abdominal contents through the obturator foramen. Symptoms are often nonspecific, and the patient usually presents with an acute or subacute intestinal obstruction. A high index of suspicion is needed in such females presenting with abdominal distention and positive Howship-Romberg signs. Computed tomography of the abdomen and pelvis are often necessary to arrive at a diagnosis, and immediate surgical intervention is recommended. The high postoperative morbidity and mortality are often attributed to a delay in the diagnosis and in initiating treatment. We present a case of a 65-year-old lady with strangulated obturator hernia who underwent emergent, lower midline laparotomy with resection and anastomosis of the small bowel and purse-string repair of the hernial defect.