Obturator hernia: a continuing diagnostic challenge.

Background. The rare obturator hernia has a high incidence of potentially lethal complications. This report reviews this condition and stresses the dangers of unrecognized obturator hernia. Methods. Thirteen patients with 14 obturator hernias were seen during a 5-year period. All the patients were emaciated and elderly, and 12 were women. They all had clinical features of small bowel obstruction. The classic Howship-Romberg sign was present in only three patients. The diagnosis was made before surgery in five patients. Results. All hernial sacs contained small bowel. Ileum were present in 11 instances