Thirty-six cases of obturator hernia: Does computed tomography contribute to postoperative outcome?

Obturator hernia is relatively rare and occurs mostly in elderly, thin, mul tiparous women. Recent reports have highlighted the importance of pelvic co mputed tomography (CT) for the preoperative diagnosis. Thirty-six patients with an obturator hernia operated in our hospital were divided retrospectiv ely into tno groups (group A 18 operations from 1973 to 1986, before we use d CT; group B: 18 CT cases from 1987 to 1995). Preoperative diagnoses, oper ative procedures, and postoperative course were reviewed. No statistically significant differences were found between groups A and B in terms of patie nt characteristics. Rates of accurate preoperative diagnoses were significa ntly higher in group B: 39% (7/18) in group A and 78%, (14/18) in group B ( p = 0.018). The intraoperative findings, occurrence of postoperative compli cations, and overall mortality rates were similar between the two groups. T here were four postoperative deaths (mortality rate 11%). Three of four pat ients who died had panperitonitis because of small bowel perforation. The c orrect preoperative diagnosis of obturator hernia was facilitated by CT of the pelvis, but it has no impact on patient outcome. Early diagnosis and su rgical intervention are essential for this rare entity.