A Case of Broad Ligament Hernia Successfully Diagnosed by Abdominal Computed Tomography.

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Internal hernias are uncommon, especially broad ligament hernia. Preoperative diagnosis of this disease is considered to be very difficult. We experienced a case of broad ligament hernia in which preoperative abdominal CT findings was helpful to make the diagnosis. A 49-year-old woman without any previous surgical history was admitted to the hospital because of abdominal pain and vomiting. Abdominal X-P showed niveau sign. She was treated conservatively with a long tube, but no symptomatic remission was obtained at the next day. Abdominal CT scan showed ascitis and several air-fluid levels of the small bowel deviated the uterus to the left side in the small pelvic cavity. We considered a broad-ligament hernia, and performed an emergency operation. Surgical exploration showed that there was an about 2cm defect in the right broad-ligament with a portion of ileum about 3cm in length, 60cm from the ileocecal valve herniated through this hiatus. The herniated ileum was releaced from obustruction and the hiatus was sutured. Any resection of the ileum was not performed. Is has been known that broad ligament hernia is rare disease entity and presents difficulty in diagnosis preoperatively. We report a case of broad ligament hernias in which preoperative abdominal CT scan, it provided clues for the diagnosis.
日本臨床外科学会の論文