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Case Report
 
Concomitant obturator hernia and midgut volvulus in an elderly woman
Yeung Kwok-Wan1, Chang Ming-Sung2
1MD, Department of Radiology, Fooyin University Hospital, Pingtung, Taiwan.
2MD, Department of Surgery, Fooyin University Hospital, Pingtung, Taiwan.

doi:10.5348/ijcri-2013-08-347-CR-6

Address correspondence to:
Kwok-Wan Yeung
Department of Radiology, Fooyin University Hospital
no.5, Chung-Shan Road, Tung-Kang
Pingtung, 928
Taiwan
Phone: 886-8-8323146 ext. 1305
Fax: 886-8-8327244
Email: kwyeung2000@gmail.com

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How to cite this article:
Kwok-Wan Y, Ming-Sung C. Concomitant obturator hernia and midgut volvulus in an elderly woman. International Journal of Case Reports and Images 2013;4(8):423–426.


Abstract
Introduction: Obturator hernia is a rare hernia of the pelvic floor and accounts for less than 1% of all intra-abdominal hernias. Midgut volvulus may be primary without an associated underlying cause, or secondary to a congenital or acquired condition.
Case Report: A 94-year-old female patient suffered from severe and diffuse abdominal cramping pain and no stool passage for 2 days and vomiting for a day. Blood analysis revealed leukocytosis. A history of constipation and chronic obstructive pulmonary disease was noted and no intra-abdominal operation was performed in the past. Contrast-enhanced computed tomography scan showed distention of the small bowel loop, a whirl sign of the superior mesenteric artery and vein, and a short segment of distal ileum incarcerated between the right external obturator and pectineus muscles. Computed tomography scan of concomitant right obturator hernia and midgut volvulus was made, which was confirmed by surgical exploration.
Conclusion: Concomitant obturator hernia and midgut volvulus in an elderly woman is rare. Careful and thorough survey of the whole abdomen by using computed tomography prompts emergent operation to reduce the mortality and morbidity of the patient.

Keywords: Obturator hernia, Midgut volvulus


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Author Contributions
Yeung Kwok-Wan – Drafting the article, Critical revision of the article, Final approval of the version to be published
Chang Ming-Sung – Conception and design, Acquisition of data, Analysis and interpretation of data, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© Yeung Kwok-Wan et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)