Obturator hernia is a rare but well-described and occur when bowel contents pass through the obturator canal, which is the opening in the superior portion of the obturator membrane which covers the opening in the bone between the ischium and the pubic bone. The normal contents of the canal are the obturator artery, vein, and nerve.
The most common presentation of obturator hernia is a bowel obstruction and this diagnosis must be considered in all bowel obstructions in virgin abdomens, particularly in frail, elderly, and debilitated women.
The pathognomonic finding of the entrapment of small bowel between the pectineus and adductor longus muscles is the Howship-Romberg sign, which is pain on the ipsilateral medial thign of extension or medial rotation and that is relieved by flexion.
Treatment is surgical reduction, which can use the laparoscopic or open midline or Pfannenstiel approaches.