Among diseases that cause small bowel obstruction, internal hernia may result in severe outcomes. Therefore, emergency laparotomy has been often performed, but it may be invasive. We experienced a case of a broad ligament hernia of the uterus, which is relatively rare among the cases of internal hernia that were treated by less invasive laparoscopic surgery.
A 71-year-old woman came to our hospital because of abdominal pain and vomiting. Abdominal computed tomography (CT) revealed a broad ligament hernia of the uterus without intestinal ischemia. Intestinal decompression was done by inserting an ileus tube (® Long Intestinal Tube, CLINY), followed by elective laparoscopic surgery.
If intestinal ischemia can be ruled out, a less invasive laparoscopic surgery may be performed after intestinal decompression. Further, by detecting the cause of internal hernia, more safe and smooth surgery can be performed. These findings highlighted the importance of accurate CT diagnosis.
In order to perform laparoscopic surgery for internal hernia, evaluation of the presence or absence of intestinal ischemia and detection of the cause of obstruction by preoperative abdominal CT are important.
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
About The Expert
Tetsuo Sugishita
Shunsuke Kato
Aoi Ishikawa
Hidenori Takahashi
Yasuyuki Kawachi
References
PubMed