Broad ligament defect causing internal hernia: A case report and literature review.

RATIONALE: The incidence of intra-abdominal hernia is very low, ranging from 0.2% to 0.9% in autopsy cases and 0.5% to 4.1% in cases of intestinal obstruction. Broad ligament hernia accounts for 4% to 7% of all cases of intra-abdominal hernias. PATIENT CONCERNS: A 39-year-old transient woman presented with persistent lower abdominal pain for 5 hours without any obvious cause, accompanied by anal distension and no other unusual symptoms. Initially, the patient did not undergo any intervention. DIAGNOSES: The computed tomography showed that the left adnexal area had a cystic low-density shadow, gas density shadow, and a close intestinal relationship, suggesting that the thickening and tortuous intestinal tube may be an adnexal source of cystic foci to be drained. Laparoscopy revealed an internal hernia caused by a broad ligament defect on the left side. INTERVENTIONS: The patient was initially treated non-operatively, symptoms worsened and he was given a laparoscopic exploration with intraoperative repositioning of the bowel and repair of the defect. OUTCOMES: The patient started to eat on the first day after the operation when the gastrointestinal function was restored and was discharged from the hospital 3 days after the operation. In the follow-up examinations in January and June after the operation, the patient had no abdominal pain, abdominal distension, or discomfort and had normal bowel movement. LESSONS: Broad ligament hernias are rare with no specific manifestations. Abdominal computer tomography is helpful for the diagnosis of a broad ligament hernia, and it should be completed in time for the timely detection of intestinal obstruction that cannot be clearly identified. Early diagnosis of hernia can be accomplished through laparoscopy to reset the hernia and repair the defect.