Internal herniation of adnexa through a defect of the broad ligament: case report and literature review

Journal of Minimally Invasive Gynecology
Habibe Demir, Bert Scoccia

Abstract

Internal herniation through a defect of the broad ligament occurs rarely. Herniation of the ovary rather than the small intestine or colon is extremely rare. We present only the third known case of herniation of the adnexa into a broad ligament defect. A 42-year-old woman, gravida 3, para 2, aborta 1, had severe continuing right lower quadrant pain that was resistant to medical and surgical treatments. The clinical history was significant for long-standing endometriosis, 2 previous laparoscopic procedures to treat endometriosis, and chronic pelvic pain despite medical and surgical treatments. At the second laparoscopic procedure, pelvic endometriosis was excised, and a large defect of the right broad ligament was noted but not treated. At the third operation, right salpingo-oophorectomy was performed to eliminate the large broad ligament defect and the possibility of internal herniation on the right side as a possible explanation for the patient's chronic right lower quadrant pain. Postoperatively, the pain resolved, and the patient has been pain-free for 9 months. This type of internal herniation should be considered in the differential diagnosis in female patients with pelvic pain.

References

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Citations

Jan 1, 2013·The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences·Jeffrey Dean WebsterErnst T Bohlmeijer
Jul 13, 2005·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Nobuyuki TakeyamaHirotsugu Munechika
Dec 27, 2011·Journal of Minimally Invasive Gynecology·Roopa Bangari, Dhiraj Uchil
Dec 30, 2014·Gastroenterología y hepatología·Eduardo Reyna-VillasmilMaría Labarca-Acosta
Jun 6, 2015·Journal of Minimally Invasive Gynecology·Amanda M JacksonNeil T Phippen
Dec 14, 2016·Journal of Minimally Invasive Gynecology·Mee Kristine Aas-EngErik Qvigstad
Feb 11, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Carolina Castro RuizValerio Annessi
Dec 10, 2020·Journal of Surgical Case Reports·Nicole ReyesDavid Bruce
Jul 26, 2021·International Journal of Surgery Case Reports·Yash RohatgiAbhijit Joshi

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