A Case of Hernia in the Broad Ligament of the Uterus Diagnosed by Preoperative CT

Abstract

A female patient in her 40’s visited our emergency department, complaining of lower abdominal pain. She was diagnosed as having intestinal obstruction by plain abdominal x-ray, and as a hernia in the broad ligament of the uterus by abdominal CT. Emergency surgery was performed. We examined the abdominal cavity by laparoscopy, and confirmed the presence of a dilated and incarcerated segment of the small intestine in the hiatus of the broad ligament of the uterus. Since it was judged to be difficult to perform laparoscopic surgery for this case, we converted to open surgery to resect the round ligament of the uterus for releasing the torsion. As the color of the small intestinal segment improved immediately, the small intestine was preserved. The left hiatus was opened, and the right hiatus was closed by suture. After the surgery, the patient was discharged from our hospital, after an uneventful postoperative course. We report this case with a discussion of the literature, because hernia in the broad ligament of the uterus is relatively rare.