Imaging findings of an obturator hernia: A rare cause of small bowel obstruction

Obturator hernias represent an uncommon yet clinically important etiology of small bowel obstruction, and their subtle, nonspecific presentation often delays timely diagnosis. We report the case of a 94-year-old woman who presented with nonspecific abdominal complaints and was initially found to have a nonpalpable, nonobstructing hernia that was mistakenly characterized as inguinal in origin on initial CT interpretation. She was managed for obstructing renal stones and discharged, only to return shortly thereafter with persistent symptoms; reimaging with CT identified an obstructing obturator hernia. This case illustrates an important diagnostic pitfall, underscoring the ease with which an obturator hernia may be mistaken for a more common groin hernia. Through discussion of this diagnostic challenge, this article aims to clarify the anatomic distinctions and key imaging features that differentiate obturator, femoral, and inguinal hernias. Improved diagnostic accuracy is essential in this frail patient population to enable prompt surgical management and to minimize associated morbidity and mortality.