• Strangulated obturator hernia - an unusual presentation of intestinal obstruction.

      Zeeshan, Saqib; Muhammad, Khalid; Chughtai, Jehanzeb; Ademola, Moses; Masood, Aqsa; Johnston, Sean; Department of Surgery, Midland Regional Hospital, Tullamore, Ireland., saqibzeeshan23@hotmail.com (2012-01-31)
      An 81-year-old Caucasian emaciated female presented with 3 days history of colicky abdominal pain nausea, projectile vomiting and abdominal distension. A pre-operative diagnosis of mechanical bowel obstruction was made. The absence of characteristic clinical signs in this thin elderly woman with a small bowel obstruction failed to provide a pre-operative diagnosis. She underwent a midline laparotomy and resection and anastomosis of small bowel and repair of the strangulated right obturator hernia. The high mortality rate associated with this type of abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and prompt surgical intervention if the survival rate is to be improved.