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KMID : 0371320100780010041
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Journal of the Korean Surgical Society
2010 Volume.78 No. 1 p.41 ~ p.50
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Experiences on Obturator Hernia and Review of Korean Cases
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Heo Seung-Chul
Kang Sung-Bum
Chung Jung-Kee
Hwang Ki-Tae
Ryoo Seung-Bum
Lee Taek-Gu
Park Kyu-Joo
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Abstract
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Purpose: We performed this study to share experiences in the management of obturator hernia, which is a very rare disease among elderly women, because rarity of this disease will not approve an expert institute or surgeon and because the aging society, Korea, can increase the incidence.
Methods: Patient characteristics, clinical manifestations and treatment results were retrospectively collected from the 12 obturator hernia patients since 2000 in the three hospitals of the authors. Twenty-one obturator hernia cases reported in the Korean literatures were reviewed. In addition, we analyzed clinical features and treatment results of the total 33 patients, collectively.
Results: Most of the patients were elderly women except one young, poorly nourished, male patient with pulmonary tuberculosis. Their mean age was 79.6 years. Sixty-four percent (21/33) of the patients had preoperative morbidity. Symptoms from the compression of the obturator nerve, which is an important clue to the diagnosis, were observed in 67% (22/33). Interestingly, spontaneous or suspicious-spontaneous reductions were reported in 7 (21%) patients. Abdominal CT scan was the major tool for diagnosis. Abdominal approach alone could successfully manage most cases, though 84% (27/32) needed anastomosis of the bowel. Operative mortality was 2 of the 32 cases but morbidity was 44% of the 32 patients and the mean hospital period after operation was 21 days.
Conclusion: Management of patients with obturator hernia connotes high morbidity and mortality. Sharing the experience of management, prompt diagnosis and surgical management and proper peri-operative care as well as appropriate managing the families is essential for improved results.
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KEYWORD
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Obturator hernia, Mortality, Morbidity
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