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2015 | 86 | 8 | 377-379
Article title

Laparoscopically Treated Small Bowel Obstruction Due to Internal Herniation Through the Broad Ligament

Content
Title variants
Languages of publication
EN
Abstracts
EN
The authors reported a case of small bowel obstruction secondary to internal herniation through a defect of the broad ligament. This is a rare cause of small bowel obstruction. A 42 year-old woman without previous abdominal surgery presented with episodes of abdominal pain, nausea and vomiting. Due to rather unspecific and changing symptoms and the fact that objective findings were normal the patient was discharged and admitted a couple of times before a computed tomography-scan showed small bowel obstruction. Acute diagnostic laparoscopy showed internal herniation of a loop of small bowel trapped in a 2 cm defect in the right side of the broad ligament. The defect was gently expanded bluntly and it was then possible to retract the strangulated part of the small bowel which afterwards was vital. The defect was sutured laparoscopically. The postoperative recovery was uneventful. This case demonstrates that a preoperative diagnosis is difficult and a high index of suspicion is necessary to prevent diagnostic delay. Internal herniation through a defect in the broad ligament should be considered as a differential diagnosis in female patients presenting with symptoms of small bowel obstruction without a history of prior abdominal surgery, especially in parous women.
Publisher
Year
Volume
86
Issue
8
Pages
377-379
Physical description
Dates
published
1 - 8 - 2014
received
11 - 7 - 2013
online
3 - 10 - 2014
References
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  • 3. Langan RC , Holzman K, Coblentz M: Strangulated hernia through a defect in the broad ligament: a sheep in wolf’s clothing. Hernia 2012; 16(4): 481-83.[WoS][Crossref]
  • 4. Kosaka N, Uematsu H, Kimura H et al.: Utility of multi-detector CT for pre-operative diagnosis of internal hernia through a defect in the broad ligament. Eur Radiol 2007; 17(4): 1130-33.[Crossref][WoS][PubMed]
  • 5. Varela GG, López-Loredo A, García León JF: Broad ligament hernia-associated bowel obstruction. JSLS 2007; 11(1): 127-30.[PubMed]
  • 6. Demir H, Scoccia B: Internal herniation of adnexa through a defect of the broad ligament: case report and literature review. J Minim Invasive Gynecol 2010; 17(1): 110-12.[WoS]
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  • 8. Agresta F, Michelet I, Candiotto E, Bedin N: Incarcerated internal hernia of the small intestine through a breach of the broad ligament: two cases and a literature review. JSLS 2007; 11(2): 255-57.[PubMed]
  • 9. Garcia-Oria M, Inglada J, Domingo J et al.: Small bowel obstruction due to broad ligament hernia successfully treated by laparoscopy. J Laparoendosc Adv Surg Tech A 2007; 17(5): 666-68.[WoS]
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Document Type
Publication order reference
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_pjs-2014-0068
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