A Case of Internal Hernia Through a Defect in the Broad Ligament of the Uterus that was Diagnosed Preoperatively

Abstract

We report herein on one case of preoperative diagnosis of a strangulated hernia through a defect in the broad ligament, followed by surgery. The patient was a female in her 40's with lower abdominal pain and vomiting. She was referred to our hospital for an additional checkup. Computed tomography demonstrated a dilated small bowel loop in the pelvis, and mesentery of the small bowel had impacted left head side of the uterus. A strangulated hernia was suspected. Laparotomy revealed that a 20-cm length of the ileum had herniated into the defect in the left broad ligament, and was resected followed by end-to-end anastomosis and closure of the defect. The patient was discharged after 10 days. Although we diagnosed the condition preoperatively, but were unable to avoid resection of the intestine. It is thought with the choice of diagnostic therapy that an open laparoscopy is more useful in an early stage to avoid resection of intestine for cases of ileus without any history of laparotomy.