Abstract
It is rare that intestinal obstruction caused by internal hernia arisen in a defect of the broad ligament of the uterus, especially that operated on laparoscopically which has not been reported in Japan as far as we could review. This paper reports a case of hiatus hernia of the broad ligament of the uterus diagnosed and treated by laparoscopic procedure.
A-73-year-old woman was performed a laparoscopic surgery with a diagnosis of adhesive intestinal obstruction which had been resisted conservative therapy. Exploration of the abdomen revealed that a portion of the ileum about 15cm in length located about 1m from the ileum end incalcerated into a defect of the broad ligament of the uterus from ventral to dorsal, forming an internal hernia. The incalcerated ileum was reddish violet in color, but it recovered in color after reduction of the hernia. So no intestinal resection was carried out and the hiatus was closed. Postoperative course was uneventful. In the treatment of the disease which often present difficulty in preoperative diagnosis with resultant intestinal resection due to poor blood flow in the in-calcerated intestine, laparoscopic procedure which has been increasingly indicated in wider range of diseases in recent years appears to be an excellent method for both diagnosis and treatment.
