Abstract
Intestinal herniation passing through a defect in the broad ligament of the uterus is a very rare form of internal herniation. We report the case of a 93-year-old woman who was admitted to our hospital due to nausea and vomiting. The next day, the patient developed an ileus, and a diagnosis of intestinal obstruction was made. Since her symotoms were not severe conservative therapy including a long intestinal tube was started. Given that X-ray findings suggested an internal herniation, surgery was performed.
During surgery a defect about 2 cm in size was found in the right broad ligament of the uterus ; a 30-cm-long segment of ileum originating from the ileocecal valve had herniated through this defect. Intestinal necrosis had not developed. The intestine was gently extricated. Nevertheless, some intestine was injured due to the presence of adhesions. Thus, a bowel resection was required, and the defect was sutured closed.
Since intestinal herniation often requires surgery, the diagnosis should be considered in female patients with an ileus who do not have a history of surgery so as not to miss the opportunity to operate prior to the development of necrosis.
