A case of Allen-Masters syndrome in an early pregnant woman: laparoscopic barbed suture repair of an internal small bowel obstruction due to a broad ligament hernia

Abstract

We here report a case of small bowel obstruction due to a broad ligament hernia treated successfully by laparoscopy in a very early stage of pregnancy. A 33-year-old woman with a previous laparoscopic appendectomy at age 23 presented to the emergency room with acute abdominal pain, non-responsive to analgesic therapy, and without inflammatory signs. After 12 hours, the pain increased and a CT scan revealed an occlusive small bowel syndrome. Laparoscopic exploration revealed a 30 cm loop of small bowel herniated into a left broad ligament defect, and collaterally, a similar, unobstructed, defect on the right side. We performed a successful surgical treatment, without bowel resection, and discharged the patient on day 4, with no postoperative complications. She had her dating scan 5 weeks later and delivered spontaneously following a physiological term labor. CT scan and rapid exploratory laparoscopy enabled both correct diagnosis and prompt treatment in this case of bowel herniation into a broad ligament defect in a pregnant woman.