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Broad Band Ligament Hernias: A Case Report

  • Urogynecology (P Nikpoor, Section Editor)
  • Published:
Current Obstetrics and Gynecology Reports Aims and scope Submit manuscript

Abstract

Purpose of review

Internal hernias account for 1% of all mechanical obstructions. However, internal hernias by defect of the broad ligament of the uterus are uncommon. This review aims to update our knowledge regarding this unusual pathology in order to understand its etiology and symptoms, and to aid in early diagnosis and management.

Recent findings

Since the end of the nineteenth century, fewer than 100 cases of internal hernias secondary to a defect of the broad ligament have been described. It is known that this defect in the broad uterine ligament can be congenital or acquired, leading to symptoms such as chronic pelvic pain or dyspareunia in the absence of intestinal obstruction. Because of the evolution of laparoscopic surgery, management in these cases in recent years has evolved to less invasive surgical techniques.

Summary

Abdominal wall hernias are a frequent cause of intestinal obstruction. By contrast, internal hernias represent a low incidence, with the exception of internal hernias caused by a defect of the uterine broad ligament. In this article we review all published cases of hernia related to the uterine broad ligament, and add to that series the case of a 44-year-old patient with no medical/surgical history of interest who arrived at the emergency department due to abdominal pain and absence of bowel movement, clinically compatible with intestinal obstruction. Internal hernias due to defect of the broad ligament are an unusual cause of intestinal obstruction in women. They require a high index of clinical suspicion, and their treatment is fundamentally surgical. Laparoscopy is current an appropriate approach for trained surgeons.

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Abbreviations

CT:

(Computerized tomography)

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

    Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of mayor importance

    1. Reyna-Villasmil E, Prieto Montaño J, Suárez-Torres I, Labarca-Acosta M. Internal hernia through a broad ligament defect. Gastroenterol Hepatol. 2015;38(10):583–4.

      Article  Google Scholar 

    2. •• Toolabi K, Zamanian A, Parsaei R. Bowel obstruction caused by broad ligament hernia successfully repaired by laparoscopy. Ann R Coll Surg Engl. 2018;100(4):94–6 This report perfectly details the presentation (and its laparoscopic management) of a bowel obstruction due to a broad ligament defect.

      Article  Google Scholar 

    3. Matsunami M, Kusanagi H, Hayashi K, Yamada S, Kano N. Broad ligament hernia successfully treated by laparoscopy: Case report and review of literature. Asian J Endosc Surg. 2014;7(4):327–9.

      Article  Google Scholar 

    4. Quain. Case of internal strangulation of a large portion of the ileum. Trans Pathol Soc Lond. 1861;12:103–4.

      Google Scholar 

    5. Cameron M, Janakan G, Birch D, Nazir S. A closed loop obstruction caused by entrapment of the fallopian tube and herniation through the broad ligament. Int J Surg Case Rep. 2015;12:57–9.

      Article  Google Scholar 

    6. Nozoe T, Anai H. Incarceration of small bowel herniation through a defect of the broad ligament of the uterus: report of a case. Surg Today. 2002;32(9):834–5.

      Article  Google Scholar 

    7. •• Takeyama H, Kogita Y, Nishigaki T, Yamashita M, Aikawa E, Hoshi M, et al. Broad ligament hernia successfully repaired by single-incision laparoscopy: A case report. Asian J Endosc Surg. 2018;11(3):274–6 A very interesting case report that describes a single-incision laparoscopy instead of other usual procedure.

      Article  Google Scholar 

    8. Marraoui W, Petitcolin V, Bros S, Slim K, Garcier JM, Da Ines D. Internal hernia of the broad ligament: CT diagnosis for laparoscopic management. Diagn Interv Imaging. 2012;93(7-8):621–4.

      Article  CAS  Google Scholar 

    9. Hassadia A, Saha A. Bilateral herniation of the ovaries into the anterior compartment of the pelvis. J Minim Invasive Gynecol. 2011;18(1):9.

      Article  Google Scholar 

    10. Hunt AB. Fenestra and pouches in the broad band ligament as an actual and potential cause of strangulated intraabdominal hernia. Surg Gynecol Obstet. 1934;58:906–13.

      Google Scholar 

    11. Cilley R, Poterack K, Lemmer J, Dafoe D. Defects of the broad ligament of the uterus. Am J Gastroenterol. 1986;81:389–91.

      CAS  PubMed  Google Scholar 

    12. • Bailey CR, Leeper WR, Johnson PT, Berlanstein BP, Fishman EK, Coquia SF. Richter's hernia through the broad ligament: Role of computed tomography and ultrasonography in facilitating diagnosis and rapid operative repair. Surgery. 2016;159(3):975–7 This report presents a very interesting discussion about the different imaging tests in acute abdomen related to an internal hernia.

      Article  Google Scholar 

    13. Agresta F, Michelet I, Candiotto E, Bedin N. Incarcerated internal hernia of the small intestine through a breach of the broad ligament: two cases and a literature review. JSLS. 2007;11(2):255–7.

      Article  CAS  Google Scholar 

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    Correspondence to Fernando Mendoza-Moreno.

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    Fernando Mendoza-Moreno, Enrique Ovejero-Merin, María Del Rocío Díez-Gago, Marina Pérez- González, Sonia Soto-Schutte, Manuel Díez-Alonso and Fernando Noguerales-Fragua declare no conflict of interest.

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    Mendoza-Moreno, F., Ovejero-Merino, E., Díez-Gago, M.D.R. et al. Broad Band Ligament Hernias: A Case Report. Curr Obstet Gynecol Rep 8, 35–38 (2019). https://doi.org/10.1007/s13669-019-0259-5

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    • DOI: https://doi.org/10.1007/s13669-019-0259-5

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