Prognostic Factors in Obturator Hernia
1University of Health Sciences Tepecik Training and Research Hospital, Department of General Surgery, İzmir, Turkey
DOI: 10.22514/sv.2020.16.0038 Vol.17,Issue 1,January 2021 pp.106-111
Published: 08 January 2021
Objective: Obturator hernia is a rare type of hernia that can occur in the octogenarian patients. We discuss the diagnosis, treatment and management of patients with obturator hernia, and describe the clinical presentation, laboratory and radiological findings. Material and methods: A retrospective study was performed in ten patients diagnosed with an obturator hernia between December 2008 - 2019 at a single tertiary hospital. Patients’ demographic features, clinical symptoms, laboratory and imaging data, comorbidities, surgical treatment methods, postoperative morbidity and mortalities were evaluated. Results: The patients’ mean age was 84.4 years (range between 81 - 89 years). All patients presented with symptoms of small bowel obstructions; abdominal pain located in the lower quadrant (100%), vomiting (60%), nausea (80%) and distension (60%). All patients had air-fluid levels on X-ray. We performed small intestine resection and an end to end anastomosis in four patients, resection with ileostomy in two patients and bowel reduction in four patients. Postoperatively, an anastomosis leak occurred in two patients, they were re-operated and an ileostomy was performed. In the post-op period, six patients died, and four patients survived. Conclusion: Obturator hernia is seen in octogenarian patients with symptoms of small bowel obstruction. The diagnosis is based mostly on computed tomography findings. An elevated neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and lactate levels can be used as a biomarker for the prediction of non-viable small bowel in these OH patients.
Obturator hernia, Octogenarian, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio
Semra Salimoğlu,Semra Demirli Atıcı. Prognostic Factors in Obturator Hernia. Signa Vitae. 2021. 17(1);106-111.
 Thanapaisan C, Thanapaisal C. Sixty-One Cases of Obturator Hernia in Chiangrai Regional Hospital: Retrospective Study. J Med Assoc Thai. 2006;89:2081-2085.
 Igari K, Ochiai T, Aihara A, et al. Clinical presentation of obturator hernia and review of the literature. Hernia. 2010;14:409–413.
 Petrie A, Tubbs RS, Matusz P, et al. Obturator Hernia: Anatomy, Embryology, Diagnosis, and Treatment. Clinical Anatomy. 2011;24:562–569.
 Skandalakis LJ, Skandalakis PN, Gray SW, et al. Obturator hernia. Hernia.1995;4:425-439.
 Kulkarni SR, Punamiya AR, Naniwadekar RG, et al. Obturator hernia: A diagnostic challenge. Int JSurg Case Rep. 2013;4:606–608.
 Şenol K, Bayam ME, Duman U, et al. Challenging management of obturator hernia: a report of three cases and literature review. Ulus Travma Acil Cerrahi Derg. 2016;22:297–300.
 Mantoo SK, Mak K, Tan TJ. Obturator hernia: diagnosis and treatment in the modern era. Singapore Med J. 2009;50:866-870.
 Kammori M, Mafune K, Hirashima T, et al. Forty-three cases of obturator hernia. Am J Surg. 2004;187:549-552.
 Nasir BS, Zendejas B, Ali SM, et al. Obturator hernia: the Mayo Clinic experience. Hernia. 2012;16:315-319.
 Chang SS, Shan YS, Lin YJ, et al. A review of obturator hernia and a proposed algorithm for its diagnosis and treatment. World J Surg. 2005;29:450-454.
 Köksal H, Ateş D, Nazik EE, et al. Predictive value of preoperative neutrophil-to-lymphocyte ratio while detecting bowel resection in hernia with iestinal incarceration. Ulus Travma Acil Cerrahi Derg. 2018;24:207-210.
 Xie X, Feng S, Tang Z, et al. Neutrophil-to-Lymphocyte Ratio Predicts the Severity of Incarcerated Groin Hernia. Med Sci Monit. 2017;23:5558-5563.
 Karadeniz E, Bayramoğlu A, Atamanalp SS. Sensitivity and Specificity of the Platelet-Lymphocyte Ratio and the Neutrophil-Lymphocyte Ratio in Diagnosing Acute Mesenteric Ischemia in Patients Operated on for the Diagnosis of Mesenteric Ischemia: A Retrospective Case-Control Study. J Invest Surg. 2019;19:1-8.
 Tanaka K, Hanyu N, Iida T, et al. Lactate levels in the detection of preoperative bowel strangulation. Am Surg. 2012;78:86-88.
 Luwaga RK, Galukande M, Owori FN. Serum lactate and phosphate as biomarkers of intestinal ischemia in a Ugandan tertiary hospital: a cross-sectional study. Int J Emerg Med. 2013;6:44.
 Leow JJ, How KY, Goh MH, et al. Non-operative management of obturator hernia in an elderly female. Hernia. 2014;18:431-433.
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