Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)

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A rare case of intestinal herniation due to a defect in the broad ligament of the uterus is described.The patient was a 46-year-old woman who presented with the chief complaints of epigastralgia and nausea.A plain radiogram of the abdomen revealed air-fluid levels of the small intestine, and a distended small intestine and ascites were demonstrated on the US and CT scans.The cause of the intestinal obstruction was not clear, but emergency surgery was performed for strangulated ileus because of aggravation of the symptoms.Laparotomy disclosed a fissure in the right broad ligament of the uterus and that the small intestine about 10cm long was incarcerated for about 40cm proximally to the ileum.The herniated intestine was reduced by making an incision in the hernia orifice and an intestinal resection made because of the necrosis.A retrospective CT scan suggested that an intestinal loop with congestive mesentery convergence in the Douglas'pouch is helpful for diagnosing herniation of the broad ligament of the uterus.

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