An unexpected twist in bowel obstruction: a case report

Internal hernias are a rare cause of small bowel obstruction. Broad ligament hernias are particularly rare and often present with nonspecific symptoms and subtle imaging findings, complicating diagnosis. Herein, the case of a 34-year-old female with acute colicky pain, obstipation, and intermittent constipation lasting 1 week is reported. Clinical examination revealed tachycardia, abdominal distension, and generalized tenderness. Imaging confirmed small bowel obstruction without an identifiable cause. Emergency laparoscopy revealed a 5-cm defect in the left broad ligament, through which viable bowel had herniated, resulting in a closed-loop obstruction. The herniated bowel was reduced, and the defect was closed with continuous sutures. The patient's recovery was uneventful. This case underscores the diagnostic challenges of broad ligament hernias and highlights the utility of laparoscopy as a diagnostic and therapeutic tool. Despite their rarity, broad ligament hernias should be considered in women with unexplained bowel obstruction.