Atypical presentation of an obstructed obturator hernia in a 99-year-old female: a case report

An obturator hernia is the protrusion of an organ/tissue through the obturator canal. Fondly called ‘little old lady’s hernia’, as they typically affect elderly thin female patients [7]. They are rare and difficult to clinically diagnose [2]. Diagnosis is often delayed and presentation could vary from symptoms of bowel obstruction, and pain in the groin or medial thigh [6] to atypical presentations like in our case. We report a case of a 99-year-old female with a 3-day history of low back pain, nausea and constipation. Computerized tomography scan revealed small bowel obstruction with transition point in left obturator hernia. The obstruction was successfully relieved via surgery without the need for bowel resection. This case highlights the importance of a high index of suspicion when faced with vague symptoms. Obturator hernias carry a reasonable degree of morbidity and mortality without intervention but have good outcomes if promptly managed.