A Case of Internal Herniation Through the Broad Ligament of the Uterus

Abstract

Internal herniation through a defect of the broad ligament of the uterus is very rare, and without adequate knowledge of the disease, the diagnosis could be delayed. We report a case of internal herniation of the intestine through an abnormal defect in the broad ligament of the uterus. A 32-year-old woman who had undergone a Cesarian section three years ago was admitted to our hospital with the complaints of abdominal pain and vomiting. Abdominal computed tomography (CT) showed wall edema of the segment of the small intestine in the pelvic cavity. The patient exhibited no other symptoms of ileus, and was therefore treated conservatively. The symptoms were not relieved, and a repeat CT on the following day revealed looping of the intestine and ascites, necessitating emergency surgery. Intraoperatively, dilated small intestinal loops were found within the pelvic cavity, and an abnormal defect was noted in the left broad ligament, with herniation of a 50-cm-long segment of the ileum through this defect. Since the intestinal loops showed evidence of necrosis, we performed partial resection of the involved intestine and sutured the defect. Since surgery is often required for broad ligament hernia, this condition should be borne in mind in the diagnosis of internal herniation in women.