子宮広間膜裂孔ヘルニアの１例

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  • A Case of Hiatal Hernia of the Broad Ligament of Uterus.

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Hiatal hernia of the broad ligament of uterus is a rare entity. This time we successfully repaired hiatus hernia of the broad ligament of uterus through a laparoscopic operation. A 33-year-old woman was admitted to the department of gynecology in out hospital with a suspicion of ovarian bleeding. Conservative therapy was started, but ileus symptoms occurred 2 days later and the patient was referred to the department. An emergency operation was performed with a suspicion of strangulated ileus due to volvulus of the small intestine. Laparoscopic observation disclosed caliber change on the ileum about 10cm to the ileum. This impacted intestine was pulled out laparoscopically, with a successful repair of ileus. A hernia opening was confirmed in the right pelvic base, but we decided to shift to laparotomy in order to explore causes. As a result, the hernia opening was found to be an abnormal hiatus arisen in the right broad ligament of uterus. Since no intestinal necrosis developed, operative procedures included only suture and no resection of the intestine was needed.<br> In the treatment of the disease which presents difficulty in diagnosis and demands intestinal excision in a high frequency, laparoscopic operation is thought to be of value.

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