Jejunal obstruction and perforation resulting from herniation through broad ligament. (1/18)

Internal herniation of small bowel through broad ligament causing obstruction is rare. A case of jejunal herniation through broad ligament defect with resultant obstruction and perforation is presented.  (+info)

Lipoleiomyoma of broad ligament: a case report. (2/18)

Lipoleiomyoma is a very uncommon tumor, and broad ligament of uterus is one of the rare sites. No case has been reported in last five years. This case is presented because of its rarity and its uncommon site of occurrence.  (+info)

A new perspective on nerve-sparing radical hysterectomy: nerve topography and over-preservation of the cardinal ligament. (3/18)

BACKGROUND: Nerve-sparing radical hysterectomy was established by Japanese gynecologists. They identified two parts of the cardinal ligament, namely the vascular part and the neural part, and postulated that the neural part contained the pelvic splanchnic nerves. However, our fresh cadaver studies demonstrated that these nerves ran dorsomedially in contrast to the classical concept. The aim of this study is to further validate this finding in clinical cases. METHODS: We examined the intraoperative biopsy specimens collected from the neural part of the cardinal ligament in four patients with cervical carcinoma who underwent nerve-sparing radical hysterectomy with dissection of the neural part. RESULTS: Careful dissections demonstrated that the pelvic splanchnic nerves arise from the dorsomedial side of the neural part at the bottom of the pararectal space. The neural part was composed of a connective tissue with focal positive staining by S-100 protein. CONCLUSIONS: We propose that complete dissection of the cardinal ligament should be performed during nerve-sparing hysterectomy to increase its radicality.  (+info)

Successful laparoscopic treatment of an abdominal pregnancy in the broad ligament. (4/18)

Laparoscopic management of tubal ectopic pregnancy is the ideal form of treatment in most tertiary centres. Approximately 1% of ectopic pregnancies are abdominal pregnancies and these are usually managed by laparotomy. We present the first report of successful laparoscopic treatment of a 6.5 cm abdominal pregnancy located in the broad ligament of a 25-year-old woman.  (+info)

Strangulated hernia through a defect of the broad ligament and mobile cecum: a case report. (5/18)

We report a case of 28-year-old woman presenting with small bowel obstruction. She had neither prior surgery nor delivery. An upright abdominal radiograph revealed several air-fluid levels in the small bowel in the midabdomen and the pelvic cavity. Computed tomography demonstrated a dilated small bowel loop in the Douglas's fossa,but no definite diagnosis could be made. Supportive therapy with draining the intestinal fluid by a long intestinal tube did not result in improvement,which suggested the possibility of a strangulated hernia. Exploratory laparotomy revealed mobile cecum and a 20-cm length of the ileum herniated into a defect of the right broad ligament. As a gangrenous change was recognized in the incarcerated bowel, its resection was carried out,followed by end-to-end anastomosis and closure of the defects of the broad ligament. The postoperative course was uneventful. Intestinal obstruction is a very common cause for presentation to an emergency department,while internal hernia is a rare cause of obstruction. Among internal hernias, those through defects of the broad ligament are extremely rare. Defects of the broad ligament can be either congenital or secondary to surgery, pelvic inflammatory disease,and delivery trauma. In conclusion, we emphasize that hernia of the broad ligament should be added to the list of differential diagnosis for female patients presenting with an intestinal obstruction. Early diagnosis and surgical repair reduce morbidity and mortality from strangulation.  (+info)

Broad ligament hernia-associated bowel obstruction. (6/18)

BACKGROUND AND OBJECTIVE: We present the case of a female patient 29 years of age with antecedents of laparoscopic laser ablation for endometriosis, laparoscopic appendectomy, and umbilical hernioplasty. METHODS: The patient was admitted to the hospital's emergency room for abdominal pain in the epigastrium, transfixing, irradiating to both upper quadrants and to the lumbar region, accompanied by nausea and gastrobiliary vomiting. Lipase determination was 170 mg/dL. Other laboratory findings were normal. Plain abdominal films on the patient's admission were normal, and computed tomography (CT) showed data compatible with acute pancreatitis. Without improvement during the patient's hospital stay, pain and vomiting increased in intensity and frequency. RESULTS: New abdominal x-rays revealed dilatation of small bowel loops. Management was begun for intestinal obstruction, with intravenous hydration and placement of a nasogastric tube without a good response. At 48 hours, a diagnostic laparoscopy was performed, revealing a 3-cm internal hernia in the left broad ligament in which a 20-cm segment of terminal ileum was encased. We performed liberation of the ileal segment and closed the hernial orifice by using the laparoscopic approach. CONCLUSION: The patient's evolution was excellent.  (+info)

Incarcerated internal hernia of the small intestine through a breach of the broad ligament: two cases and a literature review. (7/18)

Two cases of internal herniation through a defect in the broad ligament of the uterus are described. Both were successfully treated laparoscopically. This rare condition should be borne in mind when a middle-aged woman presents with colicky lower abdominal pain. The cause is unknown, but both congenital and acquired origins have been proposed. As far as emergency situations are concerned, laparoscopy has proven to be both a diagnostic and a therapeutic tool.  (+info)

Broad ligament pregnancy: a report of two cases. (8/18)

Broad ligament pregnancy is a rare event and diagnosis is often late in our setting. Two multiparous women in early thirties presented for routine antenatal care. Routine ultrasonography revealed midtrimester abdominal pregnancies. Broad ligament pregnancy was diagnosed in both cases at laparotomy and both had excision of pregnancy and salpingo-ophorectomy with satisfactory recovery. Ultrasonography is a useful tool in the early diagnosis of abdominal pregnancy in our environment. Routine ultrasonography in pregnancy is advocated in our setting.  (+info)

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