Strangulated hernia through a defect of the broad ligament and mobile cecum: A case report
We report a case of 28-year-old woman presenting with small bowel obstruction. She had neither prior surgery nor delivery. An upright abdominal radiograph revealed several air-fluid levels in the small bowel in the midabdomen and the pelvic cavity. Computed tomography demonstrated a dilated small bo...
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Published in | World journal of gastroenterology : WJG Vol. 12; no. 9; pp. 1479 - 1480 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Department of Surgery, Hamamatsu Red Cross Hospital, Hamamatsu, Shizuoka, Japan%Department of Surgery, Fussa Hospital, Fussa, Tokyo, Japan
07.03.2006
Baishideng Publishing Group Co., Limited |
Subjects | |
Online Access | Get full text |
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Summary: | We report a case of 28-year-old woman presenting with small bowel obstruction. She had neither prior surgery nor delivery. An upright abdominal radiograph revealed several air-fluid levels in the small bowel in the midabdomen and the pelvic cavity. Computed tomography demonstrated a dilated small bowel loop in the Douglas's fossa, but no definite diagnosis could be made. Supportive therapy with draining the intestinal fluid by a long intestinal tube did not result in improvement, which suggested the possibility of a strangulated hernia. Exploratory laparotomy revealed mobile cecum and a 20-cm length of the ileum herniated into a defect of the right broad ligament. As a gangrenous change was recognized in the incarcerated bowel, its resection was carried out, followed by endto-end anastomosis and closure of the defects of the broad ligament. The postoperative course was uneventful. Intestinal obstruction is a very common cause for presentation to an emergency department, while internal hernia is a rare cause of obstruction. Among internal hernias, those through defects of the broad ligament are extremely rare. Defects of the broad ligament can be either congenital or secondary to surgery, pelvic inflammatory disease, and delivery trauma. In conclusion, we emphasize that hernia of the broad ligament should be added to the list of differential diagnosis for female patients presenting with an intestinal obstruction. Early diagnosis and surgical repair reduce morbidity and mortality from strangulation. |
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Bibliography: | Mobile cecum Internal hernia; Broad ligament; Intestinal obstruction; Mobile cecum 14-1219/R R574 Intestinal obstruction Internal hernia Broad ligament ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 Correspondence to: Kunihiko Hiraiwa, MD, Department of Surgery, Hamamatsu Red Cross Hospital, 1-5-30 Takabayashi, Hamamatsu, Shizuoka, 430-0907, Japan. hiraiwa9215@hotmail.com Telephone: +81-53-4721151 Fax: +81-53-4723751 |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v12.i9.1479 |