Journal of

Case Reports and Images in Surgery

 
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Case Report
 
Broad ligament hernia: A rare cause of small bowel obstruction
Nicola Adanna Okeahialam1, Andrew Brodie2, Eriberto Farinella3
1MBChB, Foundation Year One House Officer, General Surgery, Lister Hospital, Stevenage, UK.
2MBChB, Core Surgical Trainee, General Surgery, Lister Hospital, Stevenage, UK.
3MD, Emergency and General Surgery Consultant, General Surgery, Lister Hospital, Stevenage, UK.

Article ID: 100013Z12NO2016
doi:10.5348/Z12-2016-13-CR-5

Address correspondence to:
Nicola Adanna Okeahialam
Flat 1, 32 Moray Road
London
UK, N4 3LG

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How to cite this article:
Okeahialam NA, Brodie A, Farinella E. Broad ligament hernia: A rare cause of small bowel obstruction. J Case Rep Images Surg 2016;2:15–18.


Abstract
Introduction: The broad ligament is a peritoneal fold attaching the fallopian tubes, ovaries and uterus to the wall and floor of the pelvis: herniation of abdominal viscera through a defect in this structure is rare and accounts for 4% of all internal hernias.
Case Report: We present the case of a 73-year-old woman with no prior surgical history presented to the emergency department with a four-day history of abdominal distension, bilious vomiting and not opening her bowels. Computed tomography (CT) scan of abdomen and pelvis showed a dilated small bowel with a transition point in the distal ileum with no definite cause of obstruction identified. As conservative management did not relieve her symptoms she was consented for a diagnostic laparoscopy which revealed internal herniation of distal ileum through a defect in the broad ligament of the uterus.
Conclusion: Small bowel obstruction due to internal herniation through a defect in the broad ligament is very rare. This diagnosis should be considered when radiological imaging is inconclusive. Early recognition is extremely important to reduce the risk of intestinal strangulation which has a high mortality rate.

Keywords: Broad ligament, Internal hernia, Laparoscopy, Small bowel obstruction


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Author Contributions
Nicola Adanna Okeahialam – Conception and design, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Andrew Brodie – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published
Eriberto Farinella – Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Nicola Adanna Okeahialam et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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