Strangulated small-bowel internal hernia through a defect in the broad ligament of the uterus presenting as acute intestinal obstruction : A case report
© 2021 The Authors..
BACKGROUND: Internal hernias rarely lead to bowel obstruction; they are caused by a natural or unnatural opening within the peritoneal cavity. Defects in the broad ligament are extremely rare. Patients present with features of intestinal obstruction and most cases are diagnosed during surgery.
CASE PRESENTATION: A 62-year-old parous woman presented with epigastric pain and attacks of vomiting for 1 week. The patient had had constipation for the last 5 days. She had no history of abdominal surgery. Abdominal examination revealed a distended abdomen with evidence of generalized abdominal tenderness.Abdominal CT scan showed evidence of intestinal obstruction. During laparotomy there were dilated small-bowel loops with an evidence of internal hernia through a 3 cm × 3 cm defect in the left broad ligament, through which a segment of strangulated terminal ileum was passing. Resection of the strangulated bowel was performed with end-to-end intestinal anastomosis. The broad ligament defect was closed with a slowly absorbable suture material.
CONCLUSION: Surgery for intestinal obstruction due to internal hernias should follow the same principles of any case of intestinal obstruction, whether performed by the open conventional technique or laparoscopically. Surgery should not be delayed, to avoid increased morbidity and mortality. During surgery it is mandatory that the surgeon looks for any other possible defects and close them to avoid recurrence. Internal hernias caused by broad ligament defects are best managed by either closure of the defect or salpingectomy; the course of the ureter must be identified during surgery to prevent injury.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
|---|---|
| Enthalten in: |
Case reports in women's health - 30(2021) vom: 13. Apr., Seite e00310 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Arif, Sardar Hassan [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Broad ligament defect |
|---|
| Anmerkungen: |
Date Revised 22.04.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.crwh.2021.e00310 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM324236344 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM324236344 | ||
| 003 | DE-627 | ||
| 005 | 20231225185903.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.crwh.2021.e00310 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1080.xml |
| 035 | |a (DE-627)NLM324236344 | ||
| 035 | |a (NLM)33868965 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Arif, Sardar Hassan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Strangulated small-bowel internal hernia through a defect in the broad ligament of the uterus presenting as acute intestinal obstruction |b A case report |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 22.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2021 The Authors. | ||
| 520 | |a BACKGROUND: Internal hernias rarely lead to bowel obstruction; they are caused by a natural or unnatural opening within the peritoneal cavity. Defects in the broad ligament are extremely rare. Patients present with features of intestinal obstruction and most cases are diagnosed during surgery | ||
| 520 | |a CASE PRESENTATION: A 62-year-old parous woman presented with epigastric pain and attacks of vomiting for 1 week. The patient had had constipation for the last 5 days. She had no history of abdominal surgery. Abdominal examination revealed a distended abdomen with evidence of generalized abdominal tenderness.Abdominal CT scan showed evidence of intestinal obstruction. During laparotomy there were dilated small-bowel loops with an evidence of internal hernia through a 3 cm × 3 cm defect in the left broad ligament, through which a segment of strangulated terminal ileum was passing. Resection of the strangulated bowel was performed with end-to-end intestinal anastomosis. The broad ligament defect was closed with a slowly absorbable suture material | ||
| 520 | |a CONCLUSION: Surgery for intestinal obstruction due to internal hernias should follow the same principles of any case of intestinal obstruction, whether performed by the open conventional technique or laparoscopically. Surgery should not be delayed, to avoid increased morbidity and mortality. During surgery it is mandatory that the surgeon looks for any other possible defects and close them to avoid recurrence. Internal hernias caused by broad ligament defects are best managed by either closure of the defect or salpingectomy; the course of the ureter must be identified during surgery to prevent injury | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Broad ligament defect | |
| 650 | 4 | |a Internal hernia | |
| 650 | 4 | |a Intestinal obstruction | |
| 650 | 4 | |a Laparoscopy | |
| 650 | 4 | |a Müllerian ducts | |
| 650 | 4 | |a Salpingectomy | |
| 700 | 1 | |a Mohammed, Ayad Ahmad |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Case reports in women's health |d 2015 |g 30(2021) vom: 13. Apr., Seite e00310 |w (DE-627)NLM264695216 |x 2214-9112 |7 nnns |
| 773 | 1 | 8 | |g volume:30 |g year:2021 |g day:13 |g month:04 |g pages:e00310 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.crwh.2021.e00310 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 30 |j 2021 |b 13 |c 04 |h e00310 | ||