OBTURATOR HERNIA AS A CAUSE OF ACUTE INTESTINAL OBSTRUCTION

Obturator hernia can be a lethal disease because of its frequent occurrence in the elderly debilitated patient, plus the relatively high frequency of strangulated bowel. Although an accurate preoperative diagnosis is not always possible, the signs and symptoms of intestinal obstruction will usually dictate early operation. The abdominal or retropubic approach allows the best exposure with easy reduction of the sac and resection of nonviable intestine if needed. Because most defects are small, simple pursestring closure of the sac is adequate. When a large defect is present, the use of a patch of peritoneum, fascia, or prosthetic cloth may be necessary. © 1968.