PubMed · 11809276
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A M Wägner, M Santaló. 2002-01-12. A correct decision?. https://doi.org/10.1016/s0140-6736(02)07375-0
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Meckel's diverticulum is reported in only 1 or 2% of the population. In most cases, it is free of clinical symptoms. The diagnostic modalities are effective in only 60-70% of all cases. The diagnostic laparoscopy is a safe and effective method for patients suffering from unclear abdominal pain with the option of a definitive surgical therapy. We describe the case of a 10-year-old girl with recurrent abdominal pain caused by a chronic subileus due to a Meckel's diverticulum in combination with a fibrous cord from the base of diverticulum to the mesenterial root. Both were resected in a laparoscopic technique.
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We report the case of a 33-year-old woman whose medical history included three normal pregnancies without previous abdominal or pelvic surgery. She presented with small bowel obstruction. An abdominal computed tomography (CT) scan study revealed air fluid levels in the pelvis. Laparoscopic exploration revealed a viable ileal loop incarcerated through the mesoligamentum teres. The intestinal loop was reduced and the broad ligament defect was closed with a laparoscopic absorbable clip. Among internal hernias, hernias through a defect in the broad ligament represent only 4-7%. Defects within the broad ligament can be either congenital (ruptured cystic structures reminiscent of the mesonephric or mullerian ducts) or secondary to operative trauma, pregnancy and birth trauma, or prior pelvic inflammatory disease. CT scan may be diagnostic by showing incarceration of a dilated intestinal loop in the Douglas pouch with air fluid levels. This is the first reputed case of a totally laparoscopic repair of a bowel incarceration through a broad ligament defect.