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Case Reports
. 2019 Mar 21;11(3):e4289.
doi: 10.7759/cureus.4289.

Rare Case of Peritonitis due to Ileal Perforation Secondary to Richter's Type of Obturator Hernia

Zahid Ali Memon  1 , Maria Aisha  2 , Laila Tul Qadar  2 , Rohan Kumar Ochani  2 , Sarrah Ali Asghar  2
Affiliations
Case Reports

Rare Case of Peritonitis due to Ileal Perforation Secondary to Richter's Type of Obturator Hernia

Zahid Ali Memon et al. Cureus. .

Abstract

Obturator hernia is an extremely rare condition accounting for almost 0.07%-1% of all abdominal wall hernias, usually occurring in the elderly and emaciated females with a history of previous abdominal surgery. The symptoms of this particular hernia are non-specific; therefore, a high index of clinical suspicion should always be made. This rare condition may lead to acute small intestinal obstruction. The pre-operative diagnosis is challenging and often misleading on occasions, especially in co-morbid cases. This leads to delayed diagnosis and surgical intervention, hence causing an increased morbidity and mortality rate. The computed tomography (CT) scan of the abdomen and pelvis is the gold standard for diagnosis. We present a case of an 80-year-old female, with known comorbid of hypertension, initially diagnosed as peritonitis and on further examination revealed strangulated obturator hernia with proximal perforation, that underwent lower midline laparotomy with resection of necrotic bowel, an end-to-end anastomosis, and repair of the defect by vicryl suture.

Keywords: comorbidity; computed tomography; hannington kiff sign; howship-romberg sign; perforation; peritonitis; richter obturator hernia; small bowel obstruction; strangulation; surgery.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Computed tomography (CT) scan of the chest and abdomen revealing dilated bowel loops
See this image and copyright information in PMC

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