A doctor in Taichung explained the rare condition of an incarcerated obturator hernia after an 85-year-old man was hospitalized when a patch of his skin turned black.
The man, surnamed Chen (陳), who had been unable to speak for more than two years due to a stroke, was hospitalized after family members found that a patch of skin 3cm in diameter on his right side near the hip bone had turned black.
After examining the skin, Kao Kuo-yao (高國堯), a doctor in the general surgery division at Taichung Tzu Chi Hospital, said cellulitis might have caused skin necrosis.
However, during surgery to clean the patch, intestinal fluids and feces leaked out, Kao said.
After a CT scan, Chen was diagnosed with an incarcerated obturator hernia, which can result in death, Kao said, adding that Chen had recovered and been discharged after emergency surgery.
Chen’s gastrointestinal tract was trapped by the obturator hernia, parts of his intestinal wall had undergone necrosis and an enterocutaneous fistula had formed, Kao said.
Obturator hernias most often occur in thin, elderly women who have given birth, he said, adding that the male-to-female ratio for the condition is about one-to-six.
Chen might have developed the hernia after his weight dropped to 35kg, perhaps due to a loss of appetite, Kao said, adding that it was fortunate his intestinal fluids had not flowed into his abdominal cavity and the necrosis did not lead to peritonitis.
Obturator hernias are a rare type of hernia that only occur in about 1.4 to 5 percent of cases, he said.
Due to a lack of unique symptoms, it is difficult to diagnose obturator hernias before surgery, he said, adding that only 20 percent of patients are diagnosed via palpation.
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