Abstract
A 43-year-old woman who presented to our night emergency medical clinic because of epigastralgia revealed no significant findings by a plain CT scan and was indicated to follow the clinical course. Thereafter a contrast-enhanced CT scan conducted for persisting symptom offered a preoperative diagnosis of strangulated intestinal obstruction caused by herniation of the broad ligament of the uterus. Emergency operation was thus performed. During the surgery, we confirmed the small intestine to have incarcerated in a defect (about 3 cm) of the peritoneum on the right side of the pouch of Douglas. The postoperative diagnosis was internal hernia through the peritoneal defect at the pouch of Douglas. There were no apparent necrotic findings so that bowel resection was unnecessary. Following the closure of the peritoneal defect, the surgery was completed. The patient's postoperative course was uneventful, and she was discharged from our hospital on the 6th postoperative day.
We present a case of internal hernia through a peritoneal defect at the pouch of Douglas, mimicking a hernia of the broad ligament of uterine for that we had difficulty in making preoperative diagnosis, together with a review of the literature.
