A Case Report of Hernia through the Broad Ligament of the Uterus with the Characteristic CT findings

Abstract

An 82-year-old woman visited our emergency department complaining of abdominal pain and vomiting. Abdominal CT revealed dilated small intestinal loops, however, the cause of the obstruction was not clear. Conservative medical management provided no relief from the symptoms. With the symptoms persisting, on the 3^rd day after admission, a long intestinal tube was inserted. On 6^th day after admission, contrast examination via the long tube revealed complete intestinal obstruction. The patient complained of lower abdominal pain, laboratory examination revealed elevation of the inflammatory marker levels, and emergency surgery was performed. Intraoperatively, the small intestine was found to be incarcerated into the broad ligament of the uterus. The herniated intestine was reduced by making an incision in the hernia orifice and the incarcerated segment of small intestine was resected, as it showed evidence of necrosis. A retrospective review of the CT images suggested that displacement of the uterus toward the left side, location of the obstruction close to the uterus, and extension of the broad ligament of the uterus are helpful findings for the diagnosis of intestinal herniation through the broad ligament of the uterus broad ligament hernia. The postoperative course was uneventful. We encountered a relatively rare case of hernia of the broad ligament of the uterus with characteristic CT findings.