右子宮広間膜裂孔ヘルニアの１例

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  • A Case of Right Broad Ligament Hernia.

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We experienced a case of internal herniation through an abnormal cul-de-sac in the right posterior lobe of broad ligament of the uterus which is considered to be a rare condition among of those internal hernias.<br> A 46-year-old woman was admitted to the hospital because of spontaneous pneumothorax. She underwent a partial resection of the lung with VATS. But she needed reoperation for relapse. She complained of acute onset of abdominal pain on the 16th postoperative day. Abdominal plain X-P showed niveau sign. Conservative therapy with a long tube did not provide symptomatic remission. Emergency laparotomy was performed under a diagnosis of strangulated ileus. A cul-de-sac in the right posterior lobe of broad ligament of the uterus was recognized. And, a trace of strangulation was found at a distance of 40cm from the ileocecal region. We diagnosed this case as intestinal obstruction caused by internal herniation through a defect in the right broad ligament. This cul-de-sac was closed by direct suture. Postoperative course was uneventful. CT findings such as displacement of the uterus caused by dilated small intestine is a significantrw feature for this disease.

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