A case of ileus caused by an internal hernia of the broad ligament of the uterus that was treated laparoscopically

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 69; no. 4; pp. 928 - 931
• Main Authors: YAMAMOTO, Norihiko, HOSODA, Youhei, MONDEN, Kazuyuki, NISHIHARA, Masayoshi, SHIMADA, Mamoru, OKA, Hiroshi
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2008
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.69.928

Hernia of the broad ligament of the uterus is attributable to a tear of the broad ligament and it is a comparatively rare pathological condition. We report a case of laparoscopic repair of a hernia of the broad ligament of the uterus that caused ileus. The patient was a 46-year-old female. She visited a clinic nearby with abdominal ache as the chief complaint. She was referred to this hospital and was admitted under the diagnosis of ileus. On the plain X-ray of the abdomen, niveau sign and enlargement of a segment of the small intestine were observed. CT findings of the abdomen at the time of admission indicated enlargement of the small intestine within the pelvis and deviation of the uterus to the left. In view of repeated onset of ileus despite the absence of history of operation and based on the tomographic image, the patient was assumed to have a hernia of the broad ligament of the uterus. However, for a definite diagnosis and treatment, it was decided to conduct a laparoscopic operation. Although the pre-operative diagnosis suggested a hernia of the right broad ligament of the uterus, the small intestine was actually incarcerated (Richter's hernia) in a defect of the left posterior lobe of the broad ligament. The operation was completed by reduction of the incarcerated small intestine and suture of the defect. The post-operative course up to remission was favorable, and the patient was discharged after 11 days.