Incarcerated obturator hernia complicated by lower limb venous thrombosis: a case report

Obturator hernia is a rare type of abdominal wall hernia, predominantly seen in elderly women. It often presents with symptoms of intestinal obstruction, which require emergency medical attention. Computed tomography scanning is a crucial diagnostic tool for this condition. This article reports the case of an 80-year-old Chinese female patient with a left-sided incarcerated obturator hernia complicated by ipsilateral intermuscular venous thrombosis in the lower limb. Emergency laparoscopic exploration revealed the simultaneous presence of an ipsilateral inguinal and femoral hernia, along with a contralateral obturator and femoral hernia. After balancing treatment urgency with systemic risk control, the patient underwent the laparoscopic transabdominal preperitoneal repair to address the left-sided incarcerated obturator hernia, femoral hernia, and inguinal hernia. Postoperatively, the patient recovered well, with significant relief of left leg pain and no progression of the thrombosis. This case highlights the complexity of diagnosing and managing incarcerated obturator hernias. Successful management relies on vigilance for atypical symptoms, precise imaging evaluation, a multidisciplinary decision-making approach prioritizing emergencies and risk stratification, and the integration of minimally invasive techniques with damage control principles.