Objective:

To report a rare case of spontaneously reduced obturator hernia documented by sequential CT imaging, highlighting its clinical significance and treatment with elective laparoscopic TAPP repair.

Approach:

• Case Presentation: A 67-year-old woman presented with acute lower abdominal pain and medial thigh pain, diagnosed with a right obturator hernia via initial CT imaging.
• Imaging and Diagnosis: Initial non-contrast CT showed incarcerated bowel in the obturator canal. After symptom resolution during transfer, repeat contrast-enhanced CT showed no herniated bowel.
• Surgical Intervention: Elective laparoscopic TAPP repair was performed three days later, confirming a widened obturator defect without incarcerated bowel.

Key Findings:

• Spontaneous resolution of an incarcerated obturator hernia was documented through sequential CT imaging.
• Surgical repair was warranted due to the risk of recurrent incarceration.
• Laparoscopic TAPP repair was performed successfully without complications.

Interpretation:

This case highlights the need to correlate imaging findings with clinical evolution, even when repeat imaging appears normal.

Limitations:

• The rarity of spontaneous reduction may limit the applicability of findings.
• Clinical signs must be carefully evaluated to avoid underdiagnosis.

Conclusion:

This case illustrates the diagnostic challenges of spontaneously reduced obturator hernias and the necessity for surgical intervention despite symptom resolution.