A case of a perforated obturator hernia with a femoral abscess treated a pectineus muscle flap

Naoki Kubo, Zyunichi Yoshizawa, Takaomi Hanaoka, Koichi Nakamura

An obturator hernia accompanied with a femoral abscess is rare, and leads to severe infection. Repeated draining is often required due to remnant abscess. We herein reported a case of a perforated obturator hernia with a femoral abscess that was successfully treated via repair using the pectineus muscle. An 84-year-old Japanese woman was referred to our hospital with appetite loss and right femoral pain. Abdominal computed tomography (CT) revealed a right obturator hernia and abscess spreading to the right thigh. Emergency surgery was performed. Intraoperative findings revealed that the abscess had formed because of a perforation in the small intestine by an incarcerated obturator hernia. We performed partial resection of the small intestine, repaired the hernial orifice, drained the right femoral abscess, and filled the cavity using the pectineus muscle. A residual abscess was not detectable following surgery, and the patient was discharged on postoperative day 63. Some patients with a perforated obturator hernia and femoral abscess have a residual abscess following surgery that requires redrainage. Nevertheless, we consider it possible to successfully treat a perforated obturator hernia with a femoral abscess via repair using the pectineus muscle.