骨盤内リンパ節郭清後に外腸骨動静脈を原因とする内ヘルニアを生じた1例

A case of internal hernia caused by external iliac artery after pelvic lymphadenectomy

腸閉塞の原因は様々である。術後腸閉塞の原因として癒着性が最多であるが，まれに脈管をヘルニア門とする内ヘルニアが原因となりうる。今回我々は，骨盤内リンパ節郭清後に外腸骨動静脈を原因とする内ヘルニアを生じ，絞扼性腸閉塞に至った1例を経験したので報告する。

The patient was a 60s woman with a history of pelvic lymphadenectomy（PLND）, who presented with severe abdominal pain. An internal hernia between the right external iliac artery and pelvic wall, leading to strangulated bowel obstruction, was observed on unenhanced CT. Intraoperative findings revealed that the small bowel had herniated into the space between the external iliac artery and iliopsoas muscle after PLND. Internal hernia due to exposed vessels is a rare cause of intestinal obstruction after PLND. It is important to diagnose the internal hernia caused by exposed vessels on imaging, to prevent surgical resection by misidentifying them as fibrous cords.