An 80-year-old woman presents with intermittent right thigh pain and partial bowel obstruction without a visible groin swelling. Howship-Romberg sign is positive (pain radiating to the inner thigh, aggravated by internal rotation and extension of the hip). What is the diagnosis?
- A Femoral hernia
- B Obturator hernia ✓
- C Inguinal hernia
- D Lumbar hernia
Explanation
Obturator hernia is a rare hernia through the obturator canal, predominantly affecting elderly, thin, multiparous women. The classic presentation includes partial bowel obstruction with inner thigh pain; the Howship-Romberg sign (pain along the medial thigh/inner knee, worsened by internal rotation and extension of the hip) results from pressure on the obturator nerve within the obturator canal. Diagnosis is typically made on CT scan as there is no visible swelling. It is associated with high strangulation risk; surgical repair (often via laparotomy or laparoscopy) with bowel resection if needed is the treatment.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.