Obturator hernia: Diagnosis by CT scan

Obturator hernia is relatively rare and is a diagnostic challenge in the emergency department because the hernial mass is usually concealed beneath the pectineus muscle. we report the case of a 72-year-old emaciated woman with an incarcerated obturator hernia. the hernia was discovered early in the emergency department by computed tomography and was reduced by emergency laparotomy. the howship-romberg sign and pain from the ipsilateral thigh to the knee are important clinical manifestations raising suspicion of obturator hernia,but these did not occur in our patient. one of the clinical clues in our patient was small-bowel obstruction of unknown origin,diagnosed by computed tomography. if the hernia is not palpable by physical examination,a ct scan of the pelvis and upper aspect of the thigh would confirm the diagnosis before operation and allow prompt treatment and better chance of patient survival.