Strangulated obturator hernia in a COVID-19 patient: a rare case presentation and the role of computed tomography in diagnosis

Abstract

Obturator hernia is a rare cause of acute abdomen resulting from a protrusion of intra-abdominal contents through the obturator foramen in the pelvis. Obturator hernia is often seen in older adults, emaciated individuals, and chronically ill women. The preoperative diagnosis of obturator hernia is frequently delayed because its nonspecific signs and symptoms complicate the diagnostic process, leading to high mortality rates. The most common clinical presentation of obturator hernia is intestinal obstruction with nausea, vomiting, and abdominal pain. Symptoms caused by the compression and irritation of the obturator nerve within the canal are less common. Open or laparoscopic surgery is the only available treatment; it allows abdominal cavity exploration and hernia reduction. The widespread and increasing use of computed tomography has played an important role in diagnosing conditions. Here, we present the case of a 90-year-old woman diagnosed with strangulated obturator hernia and coronavirus disease 2019 (COVID-19) who underwent emergency surgery at Hanoi Medical University Hospital. We emphasize the role of computed tomography in establishing a prompt preoperative diagnosis and planning an appropriate surgical intervention for this rare condition.