術前に診断し腹腔鏡下に治療した子宮広間膜裂孔ヘルニアの１例

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  • A CASE OF HIATAL HERNIA OF BROAD LIGAMENT OF UTERUS DIAGNOSED PREOPERATIVELY AND TREATED UNDER LAPAROSCOPY

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Hiatal hernia of the broad ligament of the uterus is a very rare internal hernia. This paper deals with a case of the disease diagnosed by preoperative CT scan and treated under laparoscopy.<br> A 54-year-old woman was referred to the hospital because of left lower abdominal pain. An abdominal CT scan revealed displacement of the uterus toward the right side, and a dilated small bowel loop on the left dorsal aspect of the uterus, of which the mesentery converged on the left side of the uterus. Intestinal obstruction due to a hiatal hernia of the left broad ligament of the uterus was diagnosed, and laparoscopic surgery was carried out. About a 30-cm portion of the small intestine was incarcerated into a hiatus about 2cm in diameter as a hernia opening from ventral to dorsal aspect. Without performing intestinal excision, we closed the hernia opening using 4-0 monofilament sutures.<br> Although no other case of the disease which was diagnosed preoperatively and treated under laparoscopy has been reported in Japan, the disease may be easily diagnosed if it is kept in mind as a probable diagnosis in female patients with intestinal obstruction. Laparoscopic surgery can be indicated for the disease in most cases.

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