Three cases of broad ligament of uterus hiatal hernia enforced emergency surgery ― Focusing on imaging diagnosis ―

Abstract

Preoperative diagnosis of broad ligament of uterus hiatal hernia has been seen in a number of cases in recent years. We report three cases experienced at our hospital, focusing on diagnostic imaging. Case 1: 51-years-old woman. A closed loop of small intestine was found. It was pouch type and the loop was released by traction and the hiatus was closed with sutures. Case 2: A 62-years-old woman. Strangulated bowel obstruction was suspected. It was fenestra type and the left fallopian tube was opened with a penetrating incision. Case 3: 63-years-old woman. A closed loop was found. It was pouch type and the hiatus was incised and the necrotic small intestine was partially resected. This disease is caused by mesentery fragility and presents characteristic CT findings. Treatment consists of unloading the fitted bowel, treating the hernia hiatus, and evaluating and treating the strangulated bowel. Knowledge of imaging findings, although rare, is important. By capturing the characteristic imaging findings of this hernia, a preoperative diagnosis can be made and management can be performed more safely.