Investigations-
Blood tests were performed and found to be within normal limits. Ultrasonography revealed features of small bowel obstruction and ascites. Her CT scan demonstrated a loop of small bowel (distal jejunum) herniating through the left obturator foramen between the left pectineus and obturator externus muscles (Figures 1 and 2). Fluid filled dilated proximal small bowel loops with maximum luminal diameter of 3.6cm with collapsed terminal ileum and large bowel loops were noted (Figure 1). Emphysematous changes in bilateral basal lung fields were also noted.
Figure.1. This is a plane coronal CT showing left obturator hernia and fluid filled dilated proximal small bowel loops with maximum luminal diameter of 3.6cm with collapsed terminal ileum and large bowel loops.
Figure.2. Arterial phase axial Computed tomography showing a loop of small bowel (distal jejunum) herniating through the left obturator foramen between the left pectineus and obturator externus muscles. On the opposite side, three muscular layers are clearly visible around the obturator foramen: internal obturator, external obturator, and pectineus.