Leg Pain—An Unexpected Twist

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE Journal of Emergency Medicine Pub Date : 2024-08-03 DOI:10.1016/j.jemermed.2024.07.017
Rahul Gupta MD , Cameron Gaines BA , Catherine Ginty MD
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Abstract

Background

Obturator hernia is a rare condition, often presenting with non-specific symptoms, such as thigh pain, groin pain, nausea, or vomiting. Obturator hernias are most common in thin, elderly women. Oftentimes, they are diagnosed late in the disease course resulting in complications and high morbidity and mortality.

Case Report

We present the case of a 75-year-old female who presented with right thigh pain with no other symptoms. After computed tomography (CT) of the abdomen/pelvis, the patient was found to have an incarcerated obturator hernia complicated by a small bowel obstruction, ultimately requiring urgent surgical intervention.

Why Should an Emergency Physician Be Aware of This?

Given the very general symptoms associated with the condition, the diagnosis of obturator hernia can easily be missed, leading to a delayed diagnosis, more complications, and a higher morbidity and mortality rate. Due to the risk associated with a delayed diagnosis, it is important for emergency physicians to maintain a high clinical suspicion for the diagnosis.

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腿痛--意想不到的转折
背景:闭孔疝是一种罕见疾病,通常表现为非特异性症状,如大腿疼痛、腹股沟疼痛、恶心或呕吐。闭孔疝最常见于瘦弱的老年妇女。病例报告:本病例是一名 75 岁女性的病例,她出现右大腿疼痛,但无其他症状。经过腹部/骨盆计算机断层扫描(CT),发现患者患有嵌顿性闭孔疝,并伴有小肠梗阻,最终需要紧急手术治疗。急诊医生为什么要注意这个问题?由于闭孔疝的症状非常普遍,因此很容易被漏诊,导致诊断延误、并发症增多、发病率和死亡率升高。由于延误诊断带来的风险,急诊医生在临床诊断中保持高度怀疑非常重要。
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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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