Images in Clinical Medicine
Obturator Hernia
N Engl J Med 2006; 355:1714October 19, 2006
- Article
A previously healthy 102-year-old woman was admitted with abdominal pain and a 3-day history of vomiting. She lived with relatives, but cared for herself, and was able to garden. There was no history of abdominal surgery. On examination, her abdomen was distended, she had pain in both hips, she could flex her knees, but no hernia was identifiable. Abdominal radiography revealed dilation of the small bowel (Panel A). Computed tomography showed an obturator hernia (arrow, Panel B). The hernia was surgically reduced, and an infarcted segment of the small bowel was resected. Postoperatively, despite complications of urinary sepsis and delirium, she recovered well. Twelve months later, she was still living at home, caring for herself, and able to sweep the floor at the age of 103 years.
Daniel Kam Yin Chan, M.D., M.B., B.S.
Bankstown Hospital, Bankstown NSW 2200, Australia
Daniel.chan@swsahs. nsw. gov. au
