A rare cause of intestinal obstruction: incarcerated femoral hernia, strangulated obturator hernia

Obturator hernia may occur bilaterally in association with another hernia, which is usually of the femoral type. We present a 77-year-old-woman who had abdominal pain with nausea and vomiting together with swelling of the right groin for 3 days. Incarcerated right femoral hernia and consequent mechanical small-bowel obstruction was diagnosed, and urgent operation was undertaken. As the incarcerated femoral hernia reduced spontaneously during the induction of anesthesia, a lower median incision was performed. During exploration, the real cause of mechanical intestinal obstruction was found to be a small intestinal loop strangulated in the left obturator hernia. Right femoral and left obturator hernia were repaired with preperitoneal polypropylene mesh. If there is enough time and general condition of the older patient is suitable, further diagnostic techniques for concomitant obturator hernias may be useful in patients who present with signs of incarcerated inguinal hernia and intestinal obstruction.