A Case of Internal Hernia Through a Defect of the Broad Ligament of the Uterus Diagnosed Definitively Preoperatively and Treated by Elective Laparoscopic Surgery

Abstract

A case of an internal hernia through a defect of the broad ligament of the uterus with a definite preoperative diagnosis who underwent elective laparoscopic surgery is presented. A 59-year-old woman complaining of lower abdominal pain was referred to our hospital. Abdominal computed tomography showed enlargement of small bowel and displacement of the uterus to the right side. She was diagnosed as having an internal hernia caused by a defect of the left broad ligament of the uterus. Three days after decompression of the small bowel by a nasogastric-small intestinal tube, laparoscopic surgery was performed with 3 trocars. Laparoscopic hernia reduction of 40cm of incarcerated ileum required 1-cm widening of the 4-cm diameter defect in the broad ligament, and the defect was closed by laparoscopic suture. Laparoscopic surgery for small intestinal incarceration by the broad ligament of the uterus is technically feasible in cases with a definite preoperative diagnosis and decompression of small bowel dilatation.