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子宫阔韧带复发性疝:一例报告

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

作者信息

Hashimoto Yoshifumi, Kanda Tatsuo, Chida Tadasu, Suda Kazuyoshi

机构信息

Department of Surgery, Sanjo General Hospital, TsukanomeNiigata, Sanjo, 955-0055, Japan.

Department of Surgery, Saiseikai Sanjo Hospital, Sanjo, Japan.

出版信息

Surg Case Rep. 2020 Nov 16;6(1):288. doi: 10.1186/s40792-020-01030-5.

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.

摘要

背景

经子宫阔韧带缺损处发生的肠疝是一种罕见疾病,复发病例报道较少。我们在此报告一例阔韧带疝(BLH)患者的复发病例,并对相关文献进行回顾。

病例介绍

一名53岁女性因腹痛被送至我院。她10年前在当地医院因与子宫阔韧带疝相关的小肠梗阻接受过剖腹手术。腹部盆腔增强计算机断层扫描显示,扩张肠管的肠系膜在盆腔内一条增厚的束带处汇聚,提示小肠闭袢性梗阻。患者接受了急诊剖腹手术,诊断为经右侧子宫阔韧带开口处的肠疝,该侧与之前手术的一侧相同。通过切开扩大疝孔,松解并保留嵌顿的肠段,因为缺血是可逆的。用编织丝线缝合关闭BLH的膜性缺损。

结论

尽管BLH是一种罕见疾病,但患者面临疾病复发的重大风险。对于BLH疝孔的闭合,使用不可吸收缝线可能是可取的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1570/7669980/b3c3cdb6aaea/40792_2020_1030_Fig1_HTML.jpg

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