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Special Considerations: Obturator, Femoral and Scrotal Hernias
 

Special Considerations: Obturator, Femoral and Scrotal Hernias

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  • Female predominance likely a result of multiparity, wider pelvis, larger obturator rings. High mortality rate is a reflection of the typical patient- frail, emaciated, with multiple comorbidities

Special Considerations: Obturator, Femoral and Scrotal Hernias Special Considerations: Obturator, Femoral and Scrotal Hernias Presentation Transcript

  • Special Considerations: Obturator, Femoral, and Scrotal Hernias Scott D. Steinberg, M.D. Staten Island University Hospital Staten Island, New York
  • Obturator Hernia
    • Described by Arnaud de Ronsil in 1724
    • First repair by Henry Obre in 1851
    • Represents approximately 1% of all hernias
    • 9 : 1 female to male ratio
    • Up to 70% mortality with strangulation
  • Obturator Foramen
    • Formed by rami of the ischium and pubis
    • Bilaterally in anterolateral pelvic wall, inferior to the acetabulum
    • Covered by obturator membrane
    • Internal orifice closed by preperitoneal fat
    • Contains obturator nerve and vessels
  • Obturator Foramen
  • Clinical Presentation
    • Most common presentation is intestinal obstruction
    • Howship-Romberg sign is pathognomonic (pain in medial thigh with extension, adduction, or medial rotation)
    • Hernia is not palpable externally
  • Radiographic Imaging MRI CT SCAN
  • OBTURATOR CANAL
  • Laparoscopic Repair
  • Laparoscopic Anatomy
  • Femoral Hernia
    • 5-10% of all groin hernias in adults
  • FEMORAL CANAL
  • SCROTAL HERNIA