CTで急性期の経時的変化をとらえた子宮広間膜裂孔ヘルニアの1例

Serial computed tomographic findings in the acute phase of a broad ligament hernia：a case report

内ヘルニアの1つである子宮広間膜裂孔ヘルニアはまれな疾患であり，特徴的な所見に乏しく，画像所見も周知されていないため，術前診断は決して容易ではない。我々は術前に経時的に2回のCT検査を施行し，極めて初期段階の所見，増悪過程など興味深い知見を得た子宮広間膜裂孔ヘルニアの症例を経験したので，文献的考察を加えて報告する。

A 40 s woman was transported with sudden onset of abdominal pain, but we could not determine the etiology of the pain using CT. The next day, her abdominal pain worsened, and small intestinal ischemia was suspected according to CT findings；therefore, we performed emergent laparoscopy. The small intestine was incarcerated in a defect in the broad ligament of the uterus, and we diagnosed a broad ligament hernia. Re-evaluation of the first CT images revealed that the small intestine slightly entered the broad ligament hiatus. Focusing on the positional relationship between the broad ligament and the intestinal tract may allow earlier diagnosis of this disease.