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Strangulated internal hernia due to defect in broad ligament: a case report
Nicole Reyes1, Lauren E Smith1, David Bruce1
1Grandview Medical Center, Department of Surgery, Dayton, OH, USA.
Journal of Surgical Case Reports
|December 9, 2020
Summary
A rare cause of small bowel obstruction, broad ligament defects are often missed preoperatively. This case highlights a broad ligament defect leading to strangulated bowel in a 70-year-old female.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Medical Imaging
Background:
- Small bowel obstruction (SBO) is a common surgical admission, with internal hernias accounting for 5-8% of cases.
- Broad ligament defects represent a rare cause of internal hernias, implicated in 4-7% of these cases.
- Preoperative diagnosis of broad ligament defects causing SBO is challenging due to nonspecific imaging findings and low incidence.
Observation:
- A 70-year-old female presented with symptoms suggestive of small bowel obstruction.
- Imaging studies revealed equivocal findings, delaying the definitive diagnosis.
- The patient was found to have a defect in the broad ligament of the uterus.
Findings:
- The broad ligament defect led to internal hernia formation.
- This resulted in a small bowel obstruction.
- The obstruction progressed to bowel strangulation, a surgical emergency.
Implications:
- This case underscores the importance of considering rare etiologies for SBO.
- Enhanced awareness and potentially advanced imaging techniques may improve preoperative diagnosis of broad ligament defects.
- Prompt surgical intervention is crucial for managing strangulated bowel secondary to internal hernias.
