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

Abstract

A 50–year–old woman visited the emergency room of our hospital complaining of lower abdominal pain and vomiting. Abdominal CT showed invagination of the small intestine into the pouch of Douglas and displacement of the rectum and uterus. Furthermore, we found a small intestinal loop to the left side of the uterus and vascular convergence in the invaginated mesentery. The patient was diagnosed as having bowel obstruction due to internal herniation through a defect in the broad ligament of the uterus, and emergency surgery was performed on the same day. A 30–cm long segment of the ileum was found to have invaginated through a defect on the left side of the broad ligament of the uterus. After releasing the intestine, the defect was sutured. The postoperative course was uneventful, and the patient was discharged 7 days after the surgery without any complications. We encountered a relatively rare case of internal herniation through a defect in the broad ligament of the uterus which was diagnosed preoperatively based on the characteristic CT findings.