Laparoscopic Management of Strangulated Broad Ligament Hernia

Alan A. Saber, MD, FACS; Arpit Patel, MD

Product Details
Product ID: ACS-5567
Year Produced: 2018
Length: 6 min.


Internal hernia through a broad ligament defect is a very rare clinical entity representing 4-7% of all internal hernias. Internal hernias are difficult to diagnose clinically as well as radiologically. We are presenting a case of a strangulated broad ligament hernia that was diagnosed and treated laparoscopically. Clinical presentation: A 51 year old female with history of HTN, Diabetes and lymphoma presented to ED with 3 hours acute diffuse abdominal pain with nausea and vomiting. The patient was tachycardic. Laboratory work up was significant for WBC: 2.8 and lactic acid 1.2. CT scan of the abdomen and pelvic showed evidence of small-bowel obstruction with transition point in the RLQ with possible small bowel ischemia. Procedure: Diagnostic laparoscopy revealed right broad ligament hernia with strangulated small bowel. Laparoscopic reduction of the ischemic small bowel loop was performed followed by repair closure of the broad hernia defect. At the end of the procedure the viability of the herniated small bowel loop returned to normal. Postoperatively, the patient did well and went home on day 2. Conclusion: Broad ligament hernia should be considered in the differential diagnosis of small bowel obstruction in female with no history of previous abdominal surgery. Laparoscopy is both diagnostic and therapeutic of such a rare clinical entity.