Case Report

J Minim Invasive Surg 2015; 18(4): 133-136

Published online December 15, 2015

https://doi.org/10.7602/jmis.2015.18.4.133

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

The Usefulness of Laparoscopy in the Treatment of Incarcerated Internal Hernia through a Defect in the Broad Ligament

Sungwoo Cho, M.D., Sangchul Yun, M.D.

Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Hernias through the broad ligament are rare with a reported incidence of only 4-7% of cases of internal hernias. Here, we report on a rare case of incarcerated internal hernia through a spontaneous defect in the broad ligament which was repaired using a laparoscopic technique. A 41-year-old female was admitted with colic abdominal pain. Laparoscopic exploration was performed for the diagnosis of intestinal obstruction. Laparoscopic examination confirmed an approximately 10-cm-long ileal loop herniated in the anterior to posterior direction through a left broad ligament defect. A large defect in the broad ligament was closed by an intracorporeal continuous running suture. The patient was highly satisfied with the cosmetic result. In conclusion, laparoscopy could be particularly helpful during pelvic surgery, which usually requires large skin incisions to ensure a good field of view. This approach was cosmetically effective, decreased the postoperative complications, and promoted early recovery to usual activity.

Keywords Broad ligament, Hernia, Laparoscopy

  1. Salar O, El-Sharkawy AM, Singh R, Speake W. Internal hernias: a brief review. Hernia 2013;17:373-377.
    Pubmed CrossRef
  2. Haku T, Daidouji K, Kawamura H, Matsuzaki M. Internal herniation through a defect of the broad ligament of the uterus. Abdom Imaging 2004;29:161-163.
    Pubmed CrossRef
  3. Cilley R, Poterack K, Lemmer J, Dafoe D. Defects of the broad ligament of the uterus. Am J Gastroenterol 1986;81:389-391.
    Pubmed
  4. Simstein NL. Internal herniation through a defect in the broad ligament. Am Surg 1987;53:258-259.
    Pubmed
  5. Ferrari S, Di Puppo F, Persico P, Ferrari A. Defects of the broad ligament of the uterus. J Minim Invasive Gynecol 2007;14:680- 681.
    Pubmed CrossRef
  6. Redwine DB. Symptomatic internal hernia of the broad ligament: a complication of electrocoagulation therapy of endometriosis. Obstet Gynecol 1989;73:495-496.
    CrossRef
  7. Baron A. Defect in the broad ligament and its association with intestinal strangulation. Br J Surg 1948;36:91-94.
    Pubmed CrossRef
  8. Quiroga S, Sarrias M, Sanchez JL, Rivero J. Small bowel obstruction secondary to internal hernia through a defect of the broad ligament: preoperative multi-detector CT diagnosis. Abdom Imaging 2012;37:1089-1091.
    Pubmed CrossRef
  9. Lombardo S, Baum K, Filho JD, Nirula R. Should adhesive small bowel obstruction be managed laparoscopically? A National Surgical Quality Improvement Program propensity score analysis. J Trauma Acute Care Surg 2014;76:696-703.
    Pubmed CrossRef
  10. O'Connor DB, Winter DC. The role of laparoscopy in the manage- ment of acute small-bowel obstruction: a review of over 2,000 cases. Surg Endosc 2012;26:12-17.
    Pubmed CrossRef

Article

Case Report

J Minim Invasive Surg 2015; 18(4): 133-136

Published online December 15, 2015 https://doi.org/10.7602/jmis.2015.18.4.133

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

The Usefulness of Laparoscopy in the Treatment of Incarcerated Internal Hernia through a Defect in the Broad Ligament

Sungwoo Cho, M.D., Sangchul Yun, M.D.

Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hernias through the broad ligament are rare with a reported incidence of only 4-7% of cases of internal hernias. Here, we report on a rare case of incarcerated internal hernia through a spontaneous defect in the broad ligament which was repaired using a laparoscopic technique. A 41-year-old female was admitted with colic abdominal pain. Laparoscopic exploration was performed for the diagnosis of intestinal obstruction. Laparoscopic examination confirmed an approximately 10-cm-long ileal loop herniated in the anterior to posterior direction through a left broad ligament defect. A large defect in the broad ligament was closed by an intracorporeal continuous running suture. The patient was highly satisfied with the cosmetic result. In conclusion, laparoscopy could be particularly helpful during pelvic surgery, which usually requires large skin incisions to ensure a good field of view. This approach was cosmetically effective, decreased the postoperative complications, and promoted early recovery to usual activity.

Keywords: Broad ligament, Hernia, Laparoscopy

References

  1. Salar O, El-Sharkawy AM, Singh R, Speake W. Internal hernias: a brief review. Hernia 2013;17:373-377.
    Pubmed CrossRef
  2. Haku T, Daidouji K, Kawamura H, Matsuzaki M. Internal herniation through a defect of the broad ligament of the uterus. Abdom Imaging 2004;29:161-163.
    Pubmed CrossRef
  3. Cilley R, Poterack K, Lemmer J, Dafoe D. Defects of the broad ligament of the uterus. Am J Gastroenterol 1986;81:389-391.
    Pubmed
  4. Simstein NL. Internal herniation through a defect in the broad ligament. Am Surg 1987;53:258-259.
    Pubmed
  5. Ferrari S, Di Puppo F, Persico P, Ferrari A. Defects of the broad ligament of the uterus. J Minim Invasive Gynecol 2007;14:680- 681.
    Pubmed CrossRef
  6. Redwine DB. Symptomatic internal hernia of the broad ligament: a complication of electrocoagulation therapy of endometriosis. Obstet Gynecol 1989;73:495-496.
    CrossRef
  7. Baron A. Defect in the broad ligament and its association with intestinal strangulation. Br J Surg 1948;36:91-94.
    Pubmed CrossRef
  8. Quiroga S, Sarrias M, Sanchez JL, Rivero J. Small bowel obstruction secondary to internal hernia through a defect of the broad ligament: preoperative multi-detector CT diagnosis. Abdom Imaging 2012;37:1089-1091.
    Pubmed CrossRef
  9. Lombardo S, Baum K, Filho JD, Nirula R. Should adhesive small bowel obstruction be managed laparoscopically? A National Surgical Quality Improvement Program propensity score analysis. J Trauma Acute Care Surg 2014;76:696-703.
    Pubmed CrossRef
  10. O'Connor DB, Winter DC. The role of laparoscopy in the manage- ment of acute small-bowel obstruction: a review of over 2,000 cases. Surg Endosc 2012;26:12-17.
    Pubmed CrossRef

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