A CASE OF INTERNAL HERNIA THROUGH AN ABNORMAL DEFECT IN THE BROAD LIGAMENT OF THE UTERUS, DIAGNOSED BY MAGNETIC RESONANCE IMAGING

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 63; no. 10; pp. 2543 - 2546
• Main Authors: ISHIKAWA, Toru, KYOGOKU, Takahisa, TAKAMINE, Yoshikazu, HAYASHI, Masazou
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2002
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.63.2543

We report a very rare case of internal hernia through an abnormal defect in the broad ligament of the uterus. A 51-year-old woman with no previous surgery admitted for upper abdominal pain and there was no niveau sign in plain abdominal X-ray film. Computed tomography (CT) showed right side deviation of her uterus but no dilated intestine. Magnetic resonance imaging (MRI) showed a local congestive mesentery and linear structure at the left side of her uterus. The radiologist suggested an internal hernia in the pelvic space, possibly a broad ligament or sigmoid mesenteric hernia. No other symptom of ileus was found, so we treated the patient conservatively. Symptoms did not diminish the next day, and the niveau sign was seen on X-ray film. The next day's CT showed a looped intestine and a linear structure in the pelvis, necessitating an emergency surgery. Laparotomy disclosed a fissure in the left broad ligament about 3cm in diameter and ileum incarcerated 10cm long through this defect. The intestinal constriction was reduced and the fissure sutured.