Characteristics of Intestinal Resection Cases in Obturator Hernia Surgery

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 38; no. 6; pp. 977 - 982
• Main Authors: Sekine, Shinichi, Hojo, Shozo, Sukegawa, Kenta, Hirano, Katsuhisa, Moriyama, Makoto, Shibuya, Kazuto, Hashimoto, Isaya, Yoshioka, Isaku, Okumura, Tomoyuki, Nagata, Takuya, Fujii, Tsutomu
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 30.09.2018
• Subjects: CT; Howship-Romberg sign
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.38.977

Obturator hernias are a rare but significant cause of strangulated bowel obstruction. Elderly emaciated women are considered to be predisposed to this condition with many symptoms such as Howship-Romberg sign (HRS), although the relationship to intestinal resection is poorly understood. We reviewed patients with an obturator hernia. The subjects were ten patients who underwent surgery in our department. All patients were elderly women and the mean age was 85.9 years old (79～92 yr). Only four patients (40％) had HRS. All patients were diagnosed based on computed tomography (CT) imaging. Intestinal resection was performed in 6 patients (60％). We divided the subjects into 2 groups based on the presence of intestinal resection (resected group and non-resected group). There were no significant differences between the two groups in terms of the presence of SIRS, preoperative WBC and CRP values. Preoperative duration from onset （duration of illness） was significantly longer （P<0.05） in the resected group (1.3 days in the non-resected group, 8.3 days in the resected group). In the examination of the CT images, the average value of the CT slice length was significantly longer in the resected group than the non-resected group (P<0.05). Evaluating the necessity of intestinal resection before surgery is also considered to be important in selection of the surgical procedure.