Broad Band Ligament Hernias: A Case Report

Abstract

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. 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. 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.