Obturator Hernia Presenting as Sciatica-Like Leg Pain Leading to Small Bowel Strangulation in an Elderly Female

Obturator hernias are a rare and often overlooked cause of small bowel obstruction (SBO), typically presenting with nonspecific symptoms such as nausea, vomiting, and abdominal pain.We present the case of a frail 83-year-old female who was recently hospitalized 10 days prior for intractable, sciatica-like leg pain.She later developed abdominal pain, prompting further evaluation.Computed tomography (CT) imaging revealed a small bowel obstruction with a transition point caused by a suspected obturator hernia containing strangulated small bowel.The patient underwent emergent surgical exploration, which confirmed the diagnosis.A hernia reduction, resection of ischemic jejunum, and primary anastomosis were performed.Her postoperative course was uneventful.This case emphasizes the need for high clinical suspicion for obturator hernia in elderly women with unexplained neuropathic leg pain and small bowel obstruction.