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Poster Presentation 2

The document discusses a rare case of an internal hernia through a broad ligament defect in a 47-year-old woman, highlighting its role as a cause of small bowel obstruction. Diagnosis is often challenging due to nonspecific symptoms and imaging findings, necessitating surgical exploration for effective treatment. Early surgical intervention is crucial to prevent complications like bowel ischemia.

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Kirushanth Sathiyanathan
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23 views1 page

Poster Presentation 2

The document discusses a rare case of an internal hernia through a broad ligament defect in a 47-year-old woman, highlighting its role as a cause of small bowel obstruction. Diagnosis is often challenging due to nonspecific symptoms and imaging findings, necessitating surgical exploration for effective treatment. Early surgical intervention is crucial to prevent complications like bowel ischemia.

Uploaded by

Kirushanth Sathiyanathan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

•.

When Gynecological Anatomy Becomes a Surgical Emergency: A Rare Internal Hernia Case

Kirushanth Sathiyanathan1, Nissanthan Tharmakulasingham1, Senuri Dias2, Chrishan Navarathnam1


1
Postgraduate Institute of Medicine, University of Colombo; 2Accident and Emergency, District General Hospital Avissawella

Introduction Discussion
Internal hernias are a rare cause of small bowel obstruction (SBO), accounting • Broad ligament hernias are rare but important causes
for up to 5.8% of cases. of small bowel obstruction in females
Broad ligament defect hernias are among the least common types of internal • Preoperative diagnosis is challenging due to subtle or
hernias. nonspecific imaging findings.
Symptoms are often nonspecific, and imaging findings may be subtle. • In settings with limited imaging, surgical exploration
Delayed diagnosis can lead to bowel ischemia or gangrene, underscoring the remains the most effective diagnostic and therapeutic
need for early recognition. tool.
Case Presentation
• Treatment involves:
• 47-year-old multiparous woman, no prior abdominal surgery.  Reducing hernia
• Presented with 12 hour history of severe, worsening abdominal pain more  Resecting nonviable bowel
in RIF  Closing the defect
• Ultrasound showed free fluid, no clear organ abnormality. • Laparoscopy is effective in stable patients without
• Open appendicectomy performed for suspected appendicitis. ischemia.
• Intraoperative findings: Normal appendix, dilated small bowel → converted to • Laparotomy preferred if ischemia, bowel dilation >4 cm,
exploratory laparotomy. or instability present.
• Found an internal hernia through a left broad ligament defect. • Clinical insights:
• 25 cm of necrotic bowel resected, primary anastomosis performed.  Consider broad ligament hernia in women with
• Uneventful recovery, discharged after return of bowel function. SBO and no surgical history.
 Early surgical intervention
Keywords is key to preventing
complications such as bowel ischemia.
Figure 1: Perioperative findings of a 4-cm defect in the left broad ligament,
Bowel ischemia, Broad ligament defect, Internal hernia
which allowed ileal loops to herniate through it

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