Internal Hernia through a Peritoneal Defect in the Pouch of Douglas Successfully Diagnosed and Treated by Single-incision Laparoscopic Surgery—A Case Report—

Abstract

A 41-year-old woman was admitted with abdominal pain and vomiting. Abdominal computed tomography revealed small intestinal obstruction with caliber change observed on the dorsal aspect of the uterus ; however, a definitive diagnosis could not be established. The obstruction persisted despite drainage using a long intestinal tube, necessitating single-incision laparoscopic surgery. Intraoperatively, the lower half of the small intestine was observed to be incarcerated on the right side of the pouch of Douglas. The defect was closed using suture ligature after releasing the obstruction and confirming bowel integrity. The patient was discharged on the 10^th postoperative day following an uneventful postoperative course. Few reports have described internal hernia through a peritoneal defect in the pouch of Douglas. This is the first report to describe such a case of a patient treated with single-incision laparoscopic surgery. Single-incision laparoscopic surgery is minimally invasive and excellent in deformation and a potentially useful treatment strategy.