Two cases of obturator hernia which were diagnosed by pelvic CT are described here.
Case 1: A 93-year-old woman complaining of an abdominal pain and vomiting was admitted to the hospital with a diagnosis of intestinal obstruction. Pelvic CT scan indicated incarceration of left obturator hernia. An operation was carried out. During the operation, a part of the ileal wall about 30 cm from the ileocecal region was incarcerated into the left obturator hrnia, but no necrosis nor perforation was associated.
Case 2: A 73-year-old woman was admitted to the hospital because of a severe right thigh pain, numbness of the right lower extremity, nausea and vomiting. Absolute fasting and transfusion were indicated with a diagnosis of intestinal obstruction, and ileus symptoms disappeared. Pelvic CT scan performed for searching the cause revealed a right obturator hernia. The patient was not operated on, because no incarceration of the intestine was found out. About three months later ileus symptoms recurred and pelvic CT scan confirmed incarcerated right obturator hernia. So an operation was performed. It was found that a portion of the ileal wall about 40 cm from the ileocecal region was incarcerated into the right obturator hernia and a part of the wall necrotized, which demanded an excision of the intestine.
These two cases would indicate the usefulness of pelvic CT in diagnosis of obturator hernia.