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rupture in smooth muscle tissue through which a bodily structure protrudes (同)herniation
a prosthesis used to close an opening (as to close an opening of the hard palate in cases of cleft palate)

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ヘルニア,脱腸

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/19 23:17:14」(JST)

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An obturator hernia is a rare type of hernia in the abdominal wall in which abdominal content protrudes through the obturator foramen. Because of differences in anatomy, it is much more common in women, especially multiparous and older women who have recently lost a lot of weight. The diagnosis is often made intraoperatively after presenting with bowel obstruction. A gynecologist may come across this type of hernias as a secondary finding during gynecological open surgery or laparoscopy ^[1] The Howship-Romberg sign is suggestive of an obturator hernia, exacerbated by thigh extension, medial rotation and abduction. It is characterized by lancilating pain in the medial thigh/obturator distribution, extending to the knee; caused by hernia compression of the obturator nerve.

References

^ Walid MS, Heaton RL (2009). "Pararectal and obturator hernias as incidental findings on gynecologic laparoscopy". Hernia 14 (1): 109–11. doi:10.1007/s10029-009-0515-0. PMID 19495923.

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1. 腹壁ヘルニアの概要 overview of abdominal hernias
2. 小腸閉塞：原因およびマネージメント small bowel obstruction causes and management
3. 小腸閉塞：臨床症状および診断 small bowel obstruction clinical manifestations and diagnosis

English Journal

Reply to Letter to Editor "Obturator Hernia with Kyphosis". Kim YW, Kim IY. DOI 10.1007/s10029-013-1189-1.

Leow JJ, Low JK.
Hernia : the journal of hernias and abdominal wall surgery.Hernia.2013 Dec 7. [Epub ahead of print]
PMID 24318289

Obturator nerve injury in laparoscopic inguinal hernia mesh repair.

Haninec P, Horak L, Kaiser R.Author information 3rd Faculty of Medicine, Department of Neurosurgery, Hospital Kralovske Vinohrady, Charles University, Srobarova 50, 100 34, Prague, Czech Republic, pavel.haninec@fnkv.cz.AbstractInjury to pelvic nerves during laparoscopy mostly occurs in gynecological and urological procedures. In abdominal surgery, these complications are infrequent. We present a case report of a patient who suffered a rare obturator nerve injury during a laparoscopic hernioplasty caused by clipping the nerve to the edge of the mesh. After revision and release of nerve from the clip and scars tissue, the associated pain rapidly disappeared and thigh adduction strength improved. Now, 4 years later, MRI and EMG show no sign of nerve compression.
Hernia : the journal of hernias and abdominal wall surgery.Hernia.2013 Dec;17(6):801-4. doi: 10.1007/s10029-012-0972-8. Epub 2012 Jul 27.
Injury to pelvic nerves during laparoscopy mostly occurs in gynecological and urological procedures. In abdominal surgery, these complications are infrequent. We present a case report of a patient who suffered a rare obturator nerve injury during a laparoscopic hernioplasty caused by clipping the ne
PMID 22836919

A review of 13 cases of obturator hernia.

Kohi S, Sato N, Mori Y, Uehara T, Tamura T, Minagawa N, Torigoe T, Shibao K, Higure A, Yamaguchi K.Author information Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Japan.AbstractWe reviewed clinical features of patients who we treated for obturator hernia. The subjects were 13 patients who underwent an operation for obturator hernia in our hospital between April 2002 and December 2012. The mean age was 78.5 years, and all patients were female. The mean body mass index was 16.8 kg/m(2). The Howship-Romberg sign was present in only 3 patients. All patients were correctly diagnosed by preoperative pelvic computed tomography. All patients underwent operation. Operative procedures included the laparoscopic approach in 8 patients, the open approach in 3 patients and the inguinal approach in 2 patients. The hernia hilus was repaired with a simple closure in 5 patients, and with a mesh in 8 patients. The hernia contents were small intestine in all the patients. Three patients underwent partial resection of the small intestine because of necrosis of the intestine wall. Three patients had a recurrence of the obturator hernia. In our present series, the patients with obturator hernia were slender females at an advanced age. Plevic CT was useful for the diagnosis of obturator hernia.
Journal of UOEH.J UOEH.2013 Dec;35(4):273-7.
We reviewed clinical features of patients who we treated for obturator hernia. The subjects were 13 patients who underwent an operation for obturator hernia in our hospital between April 2002 and December 2012. The mean age was 78.5 years, and all patients were female. The mean body mass index was 1
PMID 24334694