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A closed loop obstruction caused by entrapment of the fallopian tube and herniation through the broad ligament

Year: 2015

Type: article

Abstract: A 49-year-old female presented with one week history of severe abdominal pain, vomiting and constipation. Pertinent past surgical history consisted of caesarean section, laparoscopic right fallopian tube cystectomy and myomectomy. There was also recent left mastectomy and adjuvant chemotherapy for breast carcinoma. Clinical examination established a tensely distended abdomen with scanty bowel sounds but no clinical peritonism. Blood tests showed severe acute kidney injury and raised inflammatory markers. Computed tomography without intravenous contrast demonstrated small bowel obstruction of uncertain aetiology but with likely calibre change in the pelvis. At operation, the left fallopian tube had wrapped itself around ischemic bowel. A left salpingo-oophorectomy was performed to release the bowel. On closer inspection, an internal hernia caused by a defect in the broad ligament was diagnosed. This case report describes a differential of atypical small bowel obstruction to be considered when faced with a female acute abdomen.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2015.02.010

Authors: Michaella Cameron, Gnananandan Janakan, David Birch, Sarfraz Nazir

Institutions: University Hospital Lewisham, John Radcliffe Hospital

Language: English

Topic: Intestinal and Peritoneal Adhesions

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090