scholarly journals Rare Contents of an Internal Hernia through a Defect of the Broad Ligament of the Uterus

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Masafumi Takahashi ◽  
Masanori Yoshimitsu ◽  
Takuya Yano ◽  
Hitoshi Idani ◽  
Shigehiro Shiozaki ◽  
...  
Keyword(s):  
Fallopian Tube ◽  
Internal Hernia ◽  
Closed Loop ◽  
Broad Ligament ◽  
Definitive Diagnosis ◽  
Ileal Loop ◽  
History Of ◽  
The Right ◽  
Rare Hernia ◽  
Bowel Herniation

Herniation through a defect of the uterine broad ligament is a rare internal hernia that is difficult to diagnose definitively. Common hernia contents contain ileal loops. Herein, we report a rare case of internal herniation of both the ileum and fallopian tube through a defect of the broad ligament. A 52-year-old woman presented to our hospital with suprapubic pain and vomiting. She had a history of bowel obstruction following cesarean section. On abdominopelvic computed tomography, we suspected a closed-loop obstruction associated with bowel herniation in the right broad ligament. However, we could not identify an area of poor enhancement adjacent to distended small intestines. Emergency laparoscopic exploration revealed a viable ileal loop and incarcerated organ. Therefore, we switched to laparotomy that revealed the right fallopian tube as the ischemic organ. We reduced the hernia, resected necrotic right fallopian tube, and closed the defect of the broad ligament. The patient had an uneventful postoperative course. Rare hernia contents might complicate preoperative clinical diagnosis. Laparoscopy is useful for establishing a definitive diagnosis and treating broad ligament hernias.

scholarly journals Recurrence hernia in the broad ligament of the uterus: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yoshifumi Hashimoto ◽  
Tatsuo Kanda ◽  
Tadasu Chida ◽  
Kazuyoshi Suda
Keyword(s):  
Small Bowel ◽  
Rare Disease ◽  
Broad Ligament ◽  
Significant Risk ◽  
Disease Recurrence ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Bowel Segments ◽  
Hernia Orifice ◽  
Bowel Herniation

Abstract Background Bowel herniation through a defect in the broad ligament of the uterus is a rare disease and few cases of recurrence have been reported. We report herein a recurrence case of a patient with broad ligament hernia (BLH), along with a review of the literature. Case presentation A 53-year-old woman complaining of abdominal pain was transported to our hospital. She had a history of laparotomy for small-bowel obstruction associated with hernia in the broad ligament of the uterus 10 years ago at a local hospital. Abdominal pelvic contrast-enhanced computed tomography revealed that the mesentery of the dilated bowels converged at a thick band in the pelvis, suggesting closed loop obstruction of the small bowel. The patient underwent urgent laparotomy and was diagnosed with bowel herniation through an opening in the broad ligament of the uterus on the right side, which was ipsilateral with the previous surgery. The hernia orifice was widened by incision and incarcerated bowel segments were released and preserved because ischemia was reversible. The membranous defect of BLH was closed by suture with braded silk strings. Conclusions Although BLH is a rare disease, patients face a significant risk of disease recurrence. Nonabsorbable suture may be advisable for closure of the hernia orifice in BLH.

scholarly journals Internal bowel herniation through a peritoneal defect between the right fallopian tube and right ovarian vessels

2021 ◽  
Vol 14 (10) ◽  
pp. e246171
Author(s):  
Christian Bakholdt Dibbern ◽  
Eva Bergstrand-Poulsen ◽  
Waqas Farooqui ◽  
Luit Penninga
Keyword(s):  
Fallopian Tube ◽  
The Right ◽  
Bowel Herniation

scholarly journals A closed loop obstruction caused by entrapment of the fallopian tube and herniation through the broad ligament

2015 ◽  
Vol 12 ◽  
pp. 57-59 ◽  
Author(s):  
Michaella Cameron ◽  
Gnananandan Janakan ◽  
David Birch ◽  
Sarfraz Nazir
Keyword(s):  
Fallopian Tube ◽  
Closed Loop ◽  
Broad Ligament

scholarly journals Inguinal hernia in a female with broad ligament cyst as content

2021 ◽  
Vol 8 (4) ◽  
pp. 1337
Author(s):  
Arul K. Chinnappan ◽  
Shanthi P. Swaminathan ◽  
Vikas Kawarat ◽  
Rajeswari Mani ◽  
Indrajit Anandakannan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Urinary Bladder ◽  
Acute Appendicitis ◽  
Fallopian Tube ◽  
Broad Ligament ◽  
Vermiform Appendix ◽  
Lichtenstein Repair ◽  
Hernia Sac ◽  
Laparoscopic Excision ◽  
The Right

Inguinal hernia in females is relatively uncommon as compared to males. It is interesting to note that 1 male in 5 and 1 female in 50 will eventually develop an inguinal hernia in a lifetime. The hernia sac may contain unusual structures such as the vermiform appendix, acute appendicitis, ovary, fallopian tube and, urinary bladder. Here we present a case of 20-year-old female presented with complaints of swelling in the right inguinal region. Diagnosed as a case of right inguinal hernia with Broad ligament cyst as content. Managed by laparoscopic excision of cyst and then right Lichtenstein repair for inguinal hernia.

scholarly journals Unilateral absence of ovary and fallopian tube

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Dan-Dan Wang ◽  
◽  
Ning-Ning Zhang ◽  
Qing Yang ◽  
Jiao Wang ◽  
...  
Keyword(s):  
Fallopian Tube ◽  
Mature Teratoma ◽  
Pelvic Surgery ◽  
Pathological Examination ◽  
Ovarian Teratoma ◽  
Pelvic Magnetic Resonance Imaging ◽  
Acute Pelvic Pain ◽  
Laparoscopic Cystectomy ◽  
History Of ◽  
The Right

A 19-year-old young woman was admitted to our Unit for irregular menstrual cycles within 40- to 60-day intervals for 7 months. She had no history of abdomino-pelvic surgery or acute pelvic pain. Pelvic magnetic resonance imaging revealed a right ovarian mass (Figure1A & B), measuring 6.0 cm X 5.1 cm X 5.0 cm. The patient underwent laparoscopy. At the laparoscopic examination, we evidenced a right ovarian teratoma about 6.0 cm X 6.0 cm and a small mesosalpinx cyst about 2.5 cm X 2.0 cm on the right fallopian tube (Figure 2A). On the left, neither fallopian tube nor ovary was detected (Figure 2B). We performed laparoscopic cystectomy and sutured residual ovarian tissues for hemostasis. Subsequent urinary ultrasonography demonstrated a normal urinary tract without any congenital anomaly. The pathological examination confirmed the diagnosis of mature teratoma and right mesosalpinx serous cyst. The patient was successfully discharged at the third day with no complications.

scholarly journals Broad ligament ectopic pregnancy: a dilemma to diagnose

2017 ◽  
Vol 6 (5) ◽  
pp. 2109 ◽  
Author(s):  
Shweta Mittal ◽  
Vinita Gupta ◽  
Dolly Chawla ◽  
Seema Pundir
Keyword(s):  
Ectopic Pregnancy ◽  
Broad Ligament ◽  
Emergency Laparotomy ◽  
Vaginal Examination ◽  
Extrauterine Pregnancy ◽  
History Of ◽  
The Right ◽  
Cervical Motion ◽  
Cervical Motion Tenderness ◽  
Urine Pregnancy Test

Broad ligament ectopic pregnancy is a rare and serious form of extrauterine pregnancy with a high risk of maternal mortality. There are no specific clinical features. Ultrasonography may help in diagnosis but definitive diagnosis is made only during surgery. A 20-year-old woman with previous 2 abortions presented with acute abdomen. She had no history of amenorrhoea but there was history of two episodes of bleeding in the last month at an interval of 14 days, each episode lasting for two-three days. The last episode of bleeding was 10 days back. Her urine pregnancy test was done and it was positive. There was marked abdominal tenderness with guarding and rigidity. Per vaginal examination revealed marked tenderness in the right fornix and cervical motion tenderness, uterus size could not be assessed due to tenderness.  It was diagnosed as a case of ruptured ectopic pregnancy. Since she was haemodynamically unstable, emergency laparotomy was done. She had a right sided broad ligament ectopic pregnancy which had ruptured. The tissue was completely removed and haemostatic sutures were taken. High index of clinical suspicion, early diagnosis and prompt surgery is the key to management.

scholarly journals Uterine Perforation on Invasive Hydatidiform Mole during EMACO Treatment

2016 ◽  
Author(s):  
Bram Pradipta
Keyword(s):  
Hydatidiform Mole ◽  
Broad Ligament ◽  
Posterior Part ◽  
Exploratory Laparotomy ◽  
Recurrent Bleeding ◽  
Uterine Perforation ◽  
Long Term Treatment ◽  
History Of ◽  
Invasive Mole ◽  
The Right

Objective: Improving skill and knowledge to recognize and manage a rare case of uterine perforation on invasive hydatidiform mole. Method: Case report. Result: A 42 years old Indonesian woman, Parity 2 Abortus 2 with history of 2 c-sections and 2 curettage, came with chief complaint of recurrent vaginal bleeding since 4 months before admission. Patient had a history of previous curettage with indication of hydatidiform mole and recurrent bleeding with no histopathology results. On examination we found a vesicular mass with infiltration, destroying the right-front uterine corpus, size 8x6 cm with an internal echo mass. Chest x-ray showed multiple nodules in the lung. The patient, considered as low risk Gestational Trophoblastic Neoplasia patient with FIGO Score of 6, underwent chemotherapy with 2 series of methotrexate . Due to the non-declining level of -hCG, the regimen was added with EMACO. In the process of chemotherapy, the pa-tient’s-hCG declined but then she complained of major abdominal pain. Exploratory laparotomy was performed and we found a mass sized 5x5x5 cm on the right side of the uterus at the broad ligament with a rupture at the posterior part of the mass sized 0.5x0.5 cm. Upon incision of the uterus, we found a mass from the right side protruding to the isthmus of the uterus. Histopathology showed necrosis, blood and chorionic villi in myometrium corresponding to invasive mole. Patient was then given another 5 series of EMACO and her condition was unremarkable during the remaining course of treatment. Conclusion: Invasive mole treatment is determined based on the risk factors. Uterine perforation still occurred in this case regardless of the decreasing hCG level during EMACO treatment. It emphasizes the importance of clinical examination as chemotherapy responsiveness. Long-term treatment can have a good prognosis but good collaboration between the gynecologist and the patient is essential. [Indones J Obstet Gynecol 2014; 3: 162-165] Keywords: EMACO, invasive mole, perforation

scholarly journals Internal hernia caused by a free intraperitoneal staple after laparoscopic appendectomy

2018 ◽  
Vol 4 (1) ◽  
pp. 14 ◽  
Author(s):  
Lisa M. Angotti ◽  
Christopher Decker ◽  
Brittany Pahwa ◽  
Carl Rosati ◽  
Todd Beyer
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Laparoscopic Appendectomy ◽  
Internal Hernia ◽  
Closed Loop ◽  
Ease Of Use ◽  
Lower Quadrant ◽  
Transition Points ◽  
The Veil ◽  
The Right

Background: Laparoscopic appendectomy is the gold standard for treatment of appendicitis. Stapled closure of the appendiceal stump is commonly performed and has several advantages. Few prior cases have demonstrated complications from free staples left within the abdomen after the stapler has been fired.Case report: A 29-year-old female underwent laparoscopic appendectomy for acute uncomplicated appendicitis during which the appendix and mesoappendix were divided using laparoscopic gastrointestinal anastomosis (GIA) staplers. Her initial recovery was uncomplicated. She returned on postoperative day 17 with sharp mid-abdominal pain, obstipation, and emesis. Her abdomen was distended, and she had a mild leukocytosis. Computed tomography (CT) demonstrated twisted loops of dilated small bowel in the right lower quadrant with two transition points, suggestive of internal hernia with closed loop bowel obstruction. Diagnostic laparoscopy was performed through the three prior appendectomy incisions. An adhesion between the Veil of Treves and the mesentery of the ileum caused by a solitary free closed staple, remote from the staple lines, had caused an internal hernia. The hernia was reduced, and the small bowel was noted to have early ischemic discoloration. The adhesion was lysed by removing the staple from both structures. The compromised loops of bowel began to show peristaltic movement and color returned to normal, and the procedure was concluded without resection. She was discharged home the following day.Conclusions: Gastrointestinal staplers are commonly used due to ease of use and low complication rate. It is not uncommon to leave free staples in the abdomen as retrieval can be difficult and time consuming. Our case is only the second in the literature reporting an internal hernia with closed loop bowel obstruction as a complication of retained staples. Choosing the most appropriate size staple load to reduce the number of extra staples, removing free staples, or the use of an endoloop can prevent potentially devastating complications.

scholarly journals Isolated fallopian tube torsion with paraovarian cysts: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liang Qian ◽  
Xue Wang ◽  
Dingheng Li ◽  
Songyi Li ◽  
Jiashan Ding
Keyword(s):  
Abdominal Pain ◽  
Literature Review ◽  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Histopathological Diagnosis ◽  
Common Procedure ◽  
Delay In Diagnosis ◽  
Paraovarian Cyst ◽  
History Of ◽  
The Right

Abstract Background Isolated fallopian tube torsion (IFTT) is a rare cause of gynecological acute abdomen, is easily misdiagnosed and often has a delay in diagnosis. IFTT with paraovarian cysts is most frequently reported in studies. Here, we reported a patient diagnosed with IFTT associated with a paraovarian cyst, and we conducted a literature review for IFTT, aiming to identify valuable information that will be helpful for diagnosis and treatment for fallopian tube torsions. Case presentation A 13-year-old girl presented with a 10-day history of right lower abdominal pain that worsened 2 days before presentation. On presentation, ultrasound showed a 5.8 * 5.5 cm hypoechoic cyst adjacent to the right ovary, and between the cyst and ovary, a tortuous thickened tube was visualized. Laparoscopy revealed a triple torsion of the right fallopian tube with a 6-cm paraovarian cyst, and tubal conservation surgery was performed. The postoperative course was uneventful. Histopathological diagnosis revealed serous papillary cystadenoma. Conclusion Paraovarian cystic dilatation often occurs in adolescence and can induce fallopian torsion when the size of the cyst reaches 5-cm. In our review, the median age of patients diagnosed with IFTT with paraovarian cysts was 15 years old, and the main clinical manifestation was emergency abdominal pain. The associated symptoms were variable, and vomiting was the most commonly associated symptom. Salpingectomy was the most common procedure performed; however, timely surgical intervention can effectively avoid salpingectomy.

scholarly journals Small Intestinal Strangulation Due to a Rare Type of Primary Internal Hernia

2013 ◽  
Vol 98 (4) ◽  
pp. 409-411 ◽  
Author(s):  
Makoto Takeda ◽  
Yoshinori Ohnuki ◽  
Takashi Uchiyama ◽  
Osamu Kubota ◽  
Kousuke Ohishi
Keyword(s):  
Internal Hernia ◽  
Epigastric Pain ◽  
Past History ◽  
Hepatic Flexure ◽  
Rare Type ◽  
Paracolic Gutter ◽  
Internal Hernias ◽  
History Of ◽  
The Right ◽  
Severe Epigastric Pain

Abstract Internal hernias in which the gate is located in the paracolic gutter are rare. A 75-year-old man was admitted to our hospital with severe epigastric pain without past history of laparotomy and/or trauma. He was diagnosed with strangulation of the ileum by the findings of computed tomography, and the operation was performed. During laparotomy, the small intestine was found to be strangulated and to enter the retroperitoneum from the right paracolic gutter near the hepatic flexure. The patient was diagnosed with an internal hernia, which differed from a pericecal hernia in that the hernia gate was located along the paracolic gutter near the hepatic flexure far from the cecum. Hence, it was considered to be a rare type of internal hernia. We report the clinical presentation and imaging findings of this rare internal hernia.

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