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An 82-year-old woman with longstanding medial thigh pain presented with a 5-day history of constipation, vomiting, abdominal pain and distension. She was unable to pass flatus for the preceding 24 hours and had a past history of laparoscopic abdominal surgery. Computed tomography of the abdomen and pelvis revealed a right-sided obturator hernia containing a dilated loop of small bowel. She underwent emergency surgery for a right obturator hernia repair by limited laparotomy and was discharged after an extended stay complicated by postoperative atrial fibrillation.

Obturator hernias are rare, accounting for less than 1.5% of all hernias, and usually present with acute intestinal obstruction requiring emergency surgery. They are rarely diagnosed in the elective setting. We discuss two cases, a 52-year-old man and a 71-year-old woman, both presenting electively with a history suggestive of occult groin hernia; neither had a palpable lump. They both underwent out-patient herniography which demonstrated obturator hernia and both patients subsequently had elective laparoscopic repair, with good results. A high index of suspicion along with appropriate use of imaging modality allows for early identification of this rare condition. Early intervention can prevent the morbidity and mortality associated with complicated obturator hernia.