A Review of 14 Cases of Obturator Hernia

(Purpose) We clinically reviewed patients with obturator hernias who were treated in our hospital. (Subjects and Methods) The subjects were 14 patients who underwent surgery in our hospital between 2000 and 2012. The mean age was 82.8 years old, and all patients were females. The mean BMI was 18.2 k...

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Published inNihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 33; no. 7; pp. 1093 - 1096
Main Authors Kodama, Masaaki, Yamazaki, Kazuma, Kondho, Satoru, Ogura, Yukiko
Format Journal Article
LanguageJapanese
Published Japanese Society for Abdominal Emergency Medicine 30.11.2013
日本腹部救急医学会
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ISSN1340-2242
1882-4781
DOI10.11231/jaem.33.1093

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Abstract (Purpose) We clinically reviewed patients with obturator hernias who were treated in our hospital. (Subjects and Methods) The subjects were 14 patients who underwent surgery in our hospital between 2000 and 2012. The mean age was 82.8 years old, and all patients were females. The mean BMI was 18.2 kg/m2. The majority of the chief complaints was vomiting or abdominal pain, and the Howship-Romberg sign was observed in 5 cases. Preoperative CT scan revealed obturator hernia in 12 patients. Preoperative duration from onset was 1-18 days. Emergency surgery was performed with the open method in all cases. (Results) Seven of the 14 patients underwent partial resection of the small intestine and the other 7 patients were saved from intestinal resection, the mean preoperative duration in whom was 4.7 days and 1.1 days, respectively. In patients with intestinal perforation, the preoperative duration was more than 3 days. The hernia hilus in 6 cases was closed with simple closure, and with artificial mesh in 6 cases. Twelve of the 14 patients were discharged or transferred to another hospital. (Conclusion) All the patients with obturator hernia were elderly females who were slender. An early CT scan should be performed for an accurate diagnosis, because early diagnosis and surgery were important to avoid intestinal resection.
AbstractList (Purpose) We clinically reviewed patients with obturator hernias who were treated in our hospital. (Subjects and Methods) The subjects were 14 patients who underwent surgery in our hospital between 2000 and 2012. The mean age was 82.8 years old, and all patients were females. The mean BMI was 18.2 kg/m2. The majority of the chief complaints was vomiting or abdominal pain, and the Howship-Romberg sign was observed in 5 cases. Preoperative CT scan revealed obturator hernia in 12 patients. Preoperative duration from onset was 1-18 days. Emergency surgery was performed with the open method in all cases. (Results) Seven of the 14 patients underwent partial resection of the small intestine and the other 7 patients were saved from intestinal resection, the mean preoperative duration in whom was 4.7 days and 1.1 days, respectively. In patients with intestinal perforation, the preoperative duration was more than 3 days. The hernia hilus in 6 cases was closed with simple closure, and with artificial mesh in 6 cases. Twelve of the 14 patients were discharged or transferred to another hospital. (Conclusion) All the patients with obturator hernia were elderly females who were slender. An early CT scan should be performed for an accurate diagnosis, because early diagnosis and surgery were important to avoid intestinal resection. 要旨:[目的]当院で経験した閉鎖孔ヘルニアについて検討した。[対象および方法]対象は過去12年間に手術を施行した14症例である。背景因子,症状,術前診断,手術方法,転帰などを検討した。[結果]全例女性,平均年齢は82.8歳で平均BMIは18.2kg/m2であった。主訴は腹痛・嘔吐が11例と多く,Howship-Romberg signは5例に認められた。腹部CT検査により12例で術前診断された。発症から手術までの期間は平均2.9日で,全例に緊急開腹手術が行われた。小腸非切除7例は平均1.1日,切除7例は平均4.7日であった。腸管穿孔例は3日以上経過していた。ヘルニア門の閉鎖は単純縫合閉鎖が6例,人工膜材使用が6例と多かった。術後経過では12例が治癒した。[結語]本症は高齢の女性に多く,診断には腹部CT検査が有用であつた。陥頓腸管の切除を回避するためには早期診断・早期治療が重要と考えられた。
(Purpose) We clinically reviewed patients with obturator hernias who were treated in our hospital. (Subjects and Methods) The subjects were 14 patients who underwent surgery in our hospital between 2000 and 2012. The mean age was 82.8 years old, and all patients were females. The mean BMI was 18.2 kg/m2. The majority of the chief complaints was vomiting or abdominal pain, and the Howship-Romberg sign was observed in 5 cases. Preoperative CT scan revealed obturator hernia in 12 patients. Preoperative duration from onset was 1-18 days. Emergency surgery was performed with the open method in all cases. (Results) Seven of the 14 patients underwent partial resection of the small intestine and the other 7 patients were saved from intestinal resection, the mean preoperative duration in whom was 4.7 days and 1.1 days, respectively. In patients with intestinal perforation, the preoperative duration was more than 3 days. The hernia hilus in 6 cases was closed with simple closure, and with artificial mesh in 6 cases. Twelve of the 14 patients were discharged or transferred to another hospital. (Conclusion) All the patients with obturator hernia were elderly females who were slender. An early CT scan should be performed for an accurate diagnosis, because early diagnosis and surgery were important to avoid intestinal resection.
Author Ogura, Yukiko
Kondho, Satoru
Kodama, Masaaki
Yamazaki, Kazuma
Author_FL 小倉 由起子
近藤 悟
山崎 一馬
児玉 多曜
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  organization: Department of Surgery, Tochigi Medical Center Shimotuga General Hospital
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  fullname: Ogura, Yukiko
  organization: Department of Surgery, Tochigi Medical Center Shimotuga General Hospital
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Nihon Fukubu Kyukyu Igakkai Zasshi
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日本腹部救急医学会
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References 7) 池田宏国, 辻 和宏, 三谷英信, ほか: 閉鎖孔ヘルニア10例の臨床的検討. 臨外 2005; 60: 787-789.
8) Meziane MA, Fishman EK, Siegelman SS: Computed tomographic diagnosis of obturator foramen hernia. Gastrointest Radiol 1983; 8: 375-377.
10) 富永哲郎, 土肥良一郎, 河野陽介, ほか: 閉鎖孔ヘルニア12症例の検討. 日腹部救急医会誌 2010; 30: 751-755.
5) 田中 覚, 三好和裕, 竹田 幹, ほか: CTで術前診断した閉鎖孔ヘルニアの1例: 本邦報告498例の検討. 大阪医大誌 2006; 65: 35-39.
14) 松本壮平, 高山智燮, 上野正闘, ほか: 腹腔鏡下手術を施行した両側閉鎖孔ヘルニアの1例. 日鏡外会誌 2009; 14: 299-305.
4) 三好康敬, 鈴江ひとみ, 坂東儀昭: 閉鎖孔ヘルニアの診断と治療. 外科治療 2009; 100: 669-675.
6) 日野恭徳, 山城守也, 中山夏太郎, ほか: 閉鎖孔ヘルニアの診断と治療. 外科 1980; 42: 816-820.
11) 工藤秀穂, 古川清憲, 横井公良, ほか: CTにて術前診断し得た閉鎖孔ヘルニア. 日腹部救急医会誌 2009; 29: 517-520.
16) 猪野 満: 閉鎖孔ヘルニア術式の検討 ─10例の経験から─. 日臨外会誌 2000; 61: 3404-3406.
2) Bjork KJ, Mucha P, Chahill DR: Obturator hernia. Surg Gynecol Obstet 1998; 167: 217-222.
3) Rogers FA: Strangurated obturator hernia. Surgery 1960; 48: 394-403.
13) 中嶋 昭, 佐藤 康, 新井健広, ほか: 閉鎖孔ヘルニアの鼠径法による修復術. 手術 1995; 49: 1829-1832.
1) 河野哲夫, 日向 理, 本田勇二: 閉鎖孔ヘルニア ─最近6年間の本邦報告257例の集計検討─. 日臨外会誌 2002; 63: 1847-1852.
9) 河合雅也, 佐藤浩一, 前川 博, ほか: 閉鎖孔ヘルニアに対する診断と治療. 日腹部救急医会誌 2010; 30: 747-749.
15) 宮田潤一, 米山桂八, 固武健二郎: 異時性に両側発症した閉鎖孔ヘルニアの1例および本邦報告例の統計的検討. 臨外 1984; 39: 1641-1644.
12) 太田英里子, 船田信顕, 安藤 稔, ほか: 閉鎖孔ヘルニアにより腸閉塞を発症した多発性嚢胞腎透析患者の剖検例. 透析会誌 2007; 40: 367-373.
References_xml – reference: 12) 太田英里子, 船田信顕, 安藤 稔, ほか: 閉鎖孔ヘルニアにより腸閉塞を発症した多発性嚢胞腎透析患者の剖検例. 透析会誌 2007; 40: 367-373.
– reference: 6) 日野恭徳, 山城守也, 中山夏太郎, ほか: 閉鎖孔ヘルニアの診断と治療. 外科 1980; 42: 816-820.
– reference: 11) 工藤秀穂, 古川清憲, 横井公良, ほか: CTにて術前診断し得た閉鎖孔ヘルニア. 日腹部救急医会誌 2009; 29: 517-520.
– reference: 2) Bjork KJ, Mucha P, Chahill DR: Obturator hernia. Surg Gynecol Obstet 1998; 167: 217-222.
– reference: 8) Meziane MA, Fishman EK, Siegelman SS: Computed tomographic diagnosis of obturator foramen hernia. Gastrointest Radiol 1983; 8: 375-377.
– reference: 4) 三好康敬, 鈴江ひとみ, 坂東儀昭: 閉鎖孔ヘルニアの診断と治療. 外科治療 2009; 100: 669-675.
– reference: 13) 中嶋 昭, 佐藤 康, 新井健広, ほか: 閉鎖孔ヘルニアの鼠径法による修復術. 手術 1995; 49: 1829-1832.
– reference: 15) 宮田潤一, 米山桂八, 固武健二郎: 異時性に両側発症した閉鎖孔ヘルニアの1例および本邦報告例の統計的検討. 臨外 1984; 39: 1641-1644.
– reference: 14) 松本壮平, 高山智燮, 上野正闘, ほか: 腹腔鏡下手術を施行した両側閉鎖孔ヘルニアの1例. 日鏡外会誌 2009; 14: 299-305.
– reference: 3) Rogers FA: Strangurated obturator hernia. Surgery 1960; 48: 394-403.
– reference: 9) 河合雅也, 佐藤浩一, 前川 博, ほか: 閉鎖孔ヘルニアに対する診断と治療. 日腹部救急医会誌 2010; 30: 747-749.
– reference: 16) 猪野 満: 閉鎖孔ヘルニア術式の検討 ─10例の経験から─. 日臨外会誌 2000; 61: 3404-3406.
– reference: 1) 河野哲夫, 日向 理, 本田勇二: 閉鎖孔ヘルニア ─最近6年間の本邦報告257例の集計検討─. 日臨外会誌 2002; 63: 1847-1852.
– reference: 7) 池田宏国, 辻 和宏, 三谷英信, ほか: 閉鎖孔ヘルニア10例の臨床的検討. 臨外 2005; 60: 787-789.
– reference: 5) 田中 覚, 三好和裕, 竹田 幹, ほか: CTで術前診断した閉鎖孔ヘルニアの1例: 本邦報告498例の検討. 大阪医大誌 2006; 65: 35-39.
– reference: 10) 富永哲郎, 土肥良一郎, 河野陽介, ほか: 閉鎖孔ヘルニア12症例の検討. 日腹部救急医会誌 2010; 30: 751-755.
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Title A Review of 14 Cases of Obturator Hernia
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