Broad ligament hernia-associated bowel obstruction.
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.


CONCLUSIONS
The patient's evolution was excellent.
Varela
G G
GG
Department of Surgery, American British Cowdray Medical Center (Centro Médico ABC), Mexico City, Mexico. surgeryabc@yahoo.com
López-Loredo
A
A
García León
J F
JF
D000328:Adult; D001956:Broad Ligament; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology* / Q000601:surgery; D006547:Hernia / Q000150:complications; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology* / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D010535:Laparoscopy