PubMed · 958976
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S R Hewitt. 1976-08-26. Ectopic pregnancy.. https://pubmed.ncbi.nlm.nih.gov/958976/
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A 51-year-old nurse underwent an uneventful TVT procedure. Two weeks postoperatively she developed intractable suprapubic pain directly over the iliopectineal ligaments consistent with a "post-colposuspension syndrome". This failed to respond to conservative therapy and she subsequently underwent exploration of the retropubic space. The TVT sling was found to be densely adherent to the iliopectineal ligaments, from which it was dissected free and then divided, leaving the part where it passes through the endopelvic fascia intact. The pain resolved immediately and the woman remained continent. This diagnosis should be considered in a woman presenting with groin pain following a sling procedure.
Malignant epithelial tumor of the broad ligament is rare and to our knowledge only 17 cases have been reported. We report a 54-year-old Japanese woman in whom transvaginal sonography (TVS) and magnetic resonance imaging (MRI) showed a left adnexal tumor. Serum CA125 was elevated to 10,000 U/ml. Preoperatively, we diagnosed this tumor was a left ovarian malignant tumor though, it was confirmed a the 47x57 mm tumor in the left broad ligament at laparotomy. Histologically most of the tumor showed serous papillary adenocarcinoma with changes similar to poorly differentiated carcinoma and as seen in transitional cell carcinoma on hematoxylin-eosin staining. After three courses of platinum based adjuvant chemotherapy, the patient is alive with no recurrence at 18 months postoperatively.
Intestinal herniation through a defect in the broad ligament of the uterus is uncommon among internal herniations. We herein report a 59-year-old woman with intestinal obstruction, who had no previous history of surgical treatment except for an appendectomy. The laparotomy revealed an incarceration of the small bowel herniation through the defect of the right broad ligament. This possibility should therefore be considered in the differential diagnosis for female patients presenting with an intestinal obstruction without any history of a prior laparotomy.