PMC3015788_01
Abdominal plain radiograph showing dilated small bowel loops in the left upper quadrant.
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F1
During the first 24 hours, an increase occurred in vomiting and abdominal pain, along with abdominal distension, for which new plain abdominal x-rays were obtained, showing dilatation of small bowel loops and a fixed loop in the left upper left quadrant (Figure 1).
The herniated small bowel loop can be observed through the broad ligament orifice.
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F2
Thus, 48 hours after hospital admission, we decided to perform a diagnostic laparoscopy, finding dilatation of small bowel loops and an internal hernia at the level of the left broad ligament (Figure 2) that had a 3-cm defect (Figure 3) with a 20-cm segment of terminal ileum incarcerated in the hernia, which was completely liberated without evidence of ischemia.
The hernial orifice and the lower portion of the uterus are seen.
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F3
Thus, 48 hours after hospital admission, we decided to perform a diagnostic laparoscopy, finding dilatation of small bowel loops and an internal hernia at the level of the left broad ligament (Figure 2) that had a 3-cm defect (Figure 3) with a 20-cm segment of terminal ileum incarcerated in the hernia, which was completely liberated without evidence of ischemia.
Simple stitches were placed to close the defect.
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F4
Closure of the defect was carried out by laparoscopy with simple 2- 0 ethibond stitches (Figures 4 and 5).
Closed hernia defect.
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F5
Closure of the defect was carried out by laparoscopy with simple 2- 0 ethibond stitches (Figures 4 and 5).