Abstract
While incarcerated hernias of the intestine usually require emergency surgery, herein, we report a case of incarcerated internal hernia occurring through the broad ligament of the uterus that was successfully reduced by a rectal examination; the hernia was then repaired by elective surgery. A 53-year-old woman visited the emergency room complaining of left lower abdominal pain and nausea of acute onset that developed while she was jogging. An abdominal contrast-enhanced CT showed a closed incarcerated loop of the sigmoid colon around the caudal aspect of the left ligamentum teres uteri. Based on this finding, the patient was diagnosed as having internal herniation of the intestine through the broad ligament of the uterus. The incarcerated bowel was palpable by rectal digital examination, and could be reduced with some manipulation, which resulted in improvement of the clinical symptoms such as the lower abdominal pain and other symptoms of bowel obstruction Thus, we avoided emergency surgery and performed a laparoscopic repair electively. Two defects were found in the broad ligament of uterus, which were sutured and closed. In addition, the mesentery of the sigmoid colon showed a linear bruise, which was considered to be the location of the incarcerated bowel. The patient recovered without postoperative complications and was discharged on postoperative day 3.
