An obturator hernia is a rare type of abdominal wall hernia in which abdominal content protrudes through the obturator foramen

Obturator foramen

The obturator foramen is the hole created by the ischium and pubis bones of the pelvis through which nerves and muscles pass.- General structure :...

. Because of differences in anatomy, it is much more common in women than in men, especially multiparous and older women who have recently lost a lot of weight. The diagnosis is often made intraoperatively after presenting
with bowel obstruction

Bowel obstruction

Bowel obstruction is a mechanical or functional obstruction of the intestines, preventing the normal transit of the products of digestion. It can occur at any level distal to the duodenum of the small intestine and is a medical emergency...

. A gynecologist may come across this type of hernias as a secondary finding during gynecological open surgery or laparoscopy The Howship-Romberg sign

Howship-Romberg sign

Howship–Romberg sign is a sign used to identify obturator hernia.It can be caused by a granuloma.It is named for John Howship and Moritz Heinrich Romberg.It should not be confused with Romberg sign.-References:...

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.