An 84-year-old woman was seen at the hospital because of vomiting, back pain, and pain of the left lower extremity. From her positive Howship-Romberg sign and pelvic CT findings, left obturator hernia was diagnosed and an emergency operation was performed. At laparotomy, the entire loop of the small intestine at about 130 cm to the ileum end was incarcerated into the left obturator and became necrotic, and then the portion was resected. We judged that closure with sutures might be impossible due to the large diameter of the left obturator, about 10 mm, and a mesh was placed on the preperitoneal cavity to repair after careful intra-abdominal lavage. No mesh infection occurred after the operation, and the patient's postoperative course was uneventful.
Recently case reports describing mesh repair for obturator hernia have been seen here and there. The method has many benefits such as tension free, easiness, and wide coverage over the obturator without injuring the obturator nerves as well as arteries and veins, but it entails a risk of mesh infection in cases in which intestinal resection is required. We think that the placement of mesh to the preperitoneal cavity after careful lavage like in this case may result in complete repaire of obturator hernia by means of the mesh method.