1/7. Falciform ligament hernia after laparoscopic cholecystectomy: a rare case and review of the literature.The occurrence of an internal hernia through a congenital or iatrogenic defect in the falciform ligament is extremely rare. In the era of minimally invasive surgery, we present an unusual case of small bowel obstruction after laparoscopic cholecystectomy. An 85-year-old white male presented to the emergency room 2 weeks after an uneventful cholecystectomy and complaining of a colicky, nonradiating right upper quadrant abdominal pain. Hydroxyiminodiacetic acid (HIDA) scan and endoscopic retrograde cholangiopancreatography (ERCP) performed revealed an open ductal system. Abdominal computed tomography (CT) scan was suggestive of a high-grade small bowel obstruction. Exploratory laparotomy revealed a herniated loop of distal ileum, passing from right to left through a defect in the falciform ligament created by the subxyphoid trochar. The surgeon should consider dividing the inferior leaf of the free edge of the falciform ligament, including the round ligament, should an aperture be created during laparoscopic port placement.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/7. An unusual complication of ureteroneocystostomy discovered at laparoscopy.BACKGROUND: laparoscopy is an important surgical technique, and an understanding of normal and altered anatomy is crucial for successful surgery. We describe herein a patient in whom the left ureter follows an anomalous course due to previous surgery. methods: This is the case report of a 28-year-old female with a history of ureteral reimplantation evaluated with laparoscopy for dysmenorrhea and infertility. RESULTS: The left ureter followed an anomalous, transperitoneal course, lateral to the fallopian tube, starting at the infundibulopelivc ligament down to its insertion in the bladder. During its transperitoneal course, the ureter perforated the ileum. CONCLUSION: This case describes an anomalous course of the ureter presumed to be due to previous childhood surgery. As more individuals with a history of ureteral reimplantation reach adulthood, an increasing number will require abdominal, surgical procedures. An understanding of potential anatomic abnormalities will reduce the risk of inadvertent visceral damage at surgery.- - - - - - - - - - ranking = 0.125keywords = ligament (Clic here for more details about this article) |
3/7. Internal herniation through the broad ligament. Case report.Two cases of internal herniation through a defect in the broad ligament of the uterus are described. This rare condition should be borne in mind when a middle-aged woman presents with colicky lower abdominal pain. The etiology is unknown, but both congenital and acquired origins have been proposed.- - - - - - - - - - ranking = 0.625keywords = ligament (Clic here for more details about this article) |
4/7. Radiologic imaging of herniation of the small bowel through a defect in the broad ligament.Internal herniation through the broad ligament is extremely rare. We report a case in which radiologic examinations including computed tomography (CT) were performed. A strangulated loop in the Douglas fossa was well-demonstrated by CT. CT can provide some clues to the diagnosis of this condition.- - - - - - - - - - ranking = 0.625keywords = ligament (Clic here for more details about this article) |
5/7. Falciform ligament aperture causing intestinal strangulation.In rare cases intestinal obstruction may be caused by herniation of small bowel through a defect in the falciform ligament. Such a case was that of a 28-year-old woman who had a 26-week twin pregnancy. She had acute upper abdominal pain. The diagnosis was acute appendicitis, but at operation a loop of ileum was found to have passed through an aperture in the falciform ligament. The loop was gangrenous and required resection. Her course was complicated by delivery of two infants on the day after operation; one died within a few hours and the other 4 months later. The patient recovered after a second operation 2 weeks later for small bowel obstruction due to adhesions. Only six other patients with this anomaly have been reported. Two were neonates. Three patients died. This complication of pregnancy has not been described before. Dislocation of the small intestine by the enlarged uterus may have contributed to the herniation. Prompt operation is mandatory in this condition as in any case of closed-loop bowel obstruction.- - - - - - - - - - ranking = 0.75keywords = ligament (Clic here for more details about this article) |
6/7. Lesser sac herniation through the greater omentum and gastro-pancreatic ligament: report of a case.We report herein the case of a woman who developed a lesser sac hernia which was especially unusual in that the small bowel prolapsed through a defect in the greater omentum and was thereafter strangulated by a hole in the gastro-pancreatic ligament. The gastro-pancreatic ligament has never before been documented as causing an internal hernia. In our patient, a plain abdominal X-ray demonstrated as soft-tissue mass displacing the stomach to the left while abdominal computed tomography and ultrasonography showed a sac-like encapsulation of the small bowel loops between the liver and stomach. Careful evaluation of these radiographic findings allowed for the preoperative diagnosis of a lesser sac hernia to be made.- - - - - - - - - - ranking = 0.75keywords = ligament (Clic here for more details about this article) |
7/7. Strangulated herniation through a defect of the broad ligament of the uterus.Among internal hernias, those through the foramen of Winslow are most commonly observed. The least frequently occurring is that through the broad ligament of the uterus. The present case presented with bowel strangulating obstruction due to a defect of the left broad ligament which could be diagnosed prior to laparotomy. The patient had no significant past history, and had symptoms of colicky pain, nausea, and vomiting. Emergency laparotomy was performed. Gangrenous ileum was resected, and a defect of the broad ligament was observed bilaterally. Past history in this case supported congenital defect of the broad ligament.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |