Obstrucción intestinal por hernia obturatriz. Caso clínico*. Drs. MARCELO FONSECA C.1,3, CEDRIC ADELSDORFER O.1,3, MILENKO SLAKO M.1,3,. PEDRO. La hernia obturatriz es una rara causa de obstrucción intestinal, se presenta en pacientes mujeres adultos mayores, desnutridos y postrados;. Request PDF on ResearchGate | On Jan 1, , E. Soto-Pérez-de-Celis and others published Hernia obturatriz, una causa poco común de obstrucción.
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Diagnosis and treatment of obturator hernia.
Hernia obturatriz, una causa poco común de obstrucción intestinal
In the elderly, intestinal obstruction carries a high mortality and its causes are different from herjia found in younger individuals. This is due to the delay in diagnosis, the high incidence of intestinal ischemia and perforation, and the affected demographics.
She presented to our emergency department with abdominal pain located in the left iliac fossa, radiating to obthratriz thigh and accompanied by nausea and constipation. We present the case of an 87 year old woman with a history of ischemic heart disease, hypothyrodism and chronic obstructive pulmonary disease.
Obturator hernia in an ageing society. Once the defect is identified, it should hrenia repaired urgently via an open or laparoscopic approach 2. The obturator foramen is located between the two ramus of the ischium and the pubis, and represents a 0.
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Due to its rarity and high mortality, every clinician facing patients with intestinal obstruction should consider it as a differential diagnosis. Abdominal computed tomography is the imaging study of choice for the diagnosis of obturator hernia 4.
The most common clinical presentation of obturator hernia is intestinal obstruction. Obturator hernia, also known as the “skinny old lady hernia” is usually found obyuratriz septuagenarian women 1.
Obturator hernia, an uncommon cause of intestinal obstruction. Ann Acad Med Singapore. The most characteristic sign is the Howship-Romberg sign, which obturayriz in a worsening of the pain with the extension, adduction and internal rotation of the extremity due to the compression of the obturator nerve 1.
A nasogastric tube was inserted and intravenous fluids were administered without clinical improvement.
A body mass index below The patient was moved to a hospital ward, where she had an uneventful recovery, and she was discharged home.
At the same time, this case illustrates the importance of abdominal tomography in select patients presenting to the emergency room with the acute abdomen or intestinal obstruction.
Intestinal obstruction is obturaatriz of the most common diseases worldwide.
Case presentation We present the case of an 87 year old woman with a history of ischemic heart disease, hypothyrodism and chronic obstructive pulmonary disease. One of such causes is obturator hernia, which usually occurs in elderly women and is very easily to detect without imaging studies.
Obturator hernia should always be considered as a differential diagnosis in elderly women with intestinal obstruction, and a thorough physical examination directed towards this entity should be performed.
Due to the lack of improvement, an abdominal tomography was obturagriz, showing a hernia of the obturator canal filled with intestinal loops Figure 1. Another classic sign is the Hannington-Kiff sign, characterized by the absence of the adductor reflex which is elicited by tapping on the adductor muscle 5 centimeters above the knee 3. Discussion Obturator hernia, also known as the “skinny old lady hernia” is usually found among septuagenarian women 1.
This hernia consists of a protrusion of the intestine through the obturator foramen in the pelvic floor. The pain experienced by our patient, originating from the lower abdomen and radiating to the anterior thigh, is usual in this entity.
Plain abdominal films showed dilated loops of small bowel with air fluid levels and absence of distal air. In women this foramen is wider, and because of that this hernia is more frequent in female patients. Physical examination revealed abdominal distension, tympanism and absence of peristaltic movements. The patient was operated by means of a medial incision with liberation of the ileum, sac ohturatriz and placement of a mesh in the defect.
No complications were reported and there was no evidence of intestinal ischemia. J Am Coll Surg.