Two Cases of Internal Hernia Through a Defect in the Broad Ligament of the Uterus Associated with Deviation of the Ovarian Vein

Abstract

【Case1】A 51-year-old woman was admitted to our hospital complaining of epigastric pain. She was diagnosed as having strangulated ileus by contrast-enhanced abdominal CT and emergent operation was performed. Intraoperative exploration revealed an internal hernia through a defect of the broad ligament of the uterus, and we reduced the hernia and sutured the defect. Postoperatively, we recognized deviation of the ovarian vein by the expanded small intestine on preoperative CT.【Case2】A 58-year-old woman was admitted to our hospital complaining of abdominal pain and nausea. On the third day of hospitalization, she was diagnosed as having strangulated ileus by contrast-enhanced abdominal CT and referred to our department. We diagnosed internal hernia through a defect of the broad ligament of the uterus and performed emergent laparoscopic surgery, because the CT showed the same findings as in Case 1. We confirmed the diagnosis by laparoscopy and converted the surgery to laparotomy for resection of the necrotic ileum and suturing of the hernia defect.