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JSLS : Journal of the Society of... 2021We sought to assess hernia characteristics and classification through comprehensive review of the literature involving broad ligament herniation. (Review)
Review
BACKGROUND
We sought to assess hernia characteristics and classification through comprehensive review of the literature involving broad ligament herniation.
METHODS
A literature search via MEDLINE and Embase databases was conducted to identify and select broad ligament herniation studies published between January 1, 2000 and September 30, 2020. Extracted data included previous surgical history, previous obstetric history, diagnostic imaging, herniated organ, hernia classification, and repair performed. The reported data has been compared to a unique case of broad ligament herniation that presented to our institution.
RESULTS
A total of 44 articles with 49 cases were identified for the study. Eighteen (36.7%) patients had a history of previous abdominal surgery while 29 (59.2%) had a history of previous childbirth. Type I (51.0%) and Type II (18.4%) defects were most commonly reported with most patients reporting only one defect (85.7%) using the Cilley classification. Twenty-nine patients underwent primary laparoscopic repair of the defect while 19 patients underwent exploratory laparotomy.
CONCLUSIONS
The analysis of previously reported cases adds to the limited literature on broad ligament hernias and highlights the surgical management of this uncommon pathology. It also highlights the need for a broad differential diagnosis when female patients present with pelvic pain or symptoms of small bowel obstruction. The broad ligament should be fully inspected when mesenteric defects are suspected as multiple defects can be present as evidenced by the attached case study.
Topics: Adult; Broad Ligament; Diagnosis, Differential; Female; Hernia; Herniorrhaphy; Humans; Intestinal Obstruction; Intestine, Small; Laparoscopy; Laparotomy; Middle Aged; Pelvic Pain
PubMed: 34248336
DOI: 10.4293/JSLS.2020.00112 -
The Journal of Obstetrics and... Jan 2021Broad ligament pregnancies are rare and are often misdiagnosed, leading to serious consequences. In our hospital, we have treated six broad ligament pregnancies since... (Review)
Review
Broad ligament pregnancies are rare and are often misdiagnosed, leading to serious consequences. In our hospital, we have treated six broad ligament pregnancies since 2000. They were diagnosed and operated on promptly, and treatment was successful. Ultrasound can detect early ectopic pregnancies promptly and effectively, avoiding advanced ectopic pregnancies. Early broad ligament pregnancies should be operated on promptly, and laparoscopic therapy is preferable. During the operation, attention must be paid to avoid massive bleeding and protect the ureter, because the ectopic gestational sac is located near the uterine artery and the ureter.
Topics: Broad Ligament; Female; Humans; Laparoscopy; Pregnancy; Pregnancy, Ectopic; Ultrasonography; Uterine Artery
PubMed: 33217160
DOI: 10.1111/jog.14564 -
Journal of Minimally Invasive Gynecology 2015The differential diagnosis of lesions arising in the broad ligament is quite large. Many of these lesions can be clinically interpreted before surgery as adnexal or... (Review)
Review
The differential diagnosis of lesions arising in the broad ligament is quite large. Many of these lesions can be clinically interpreted before surgery as adnexal or uterine neoplasms. Although some lesions are similar to those arising in other müllerian sites, there are unique lesions as well. The lesions are uncommon and may prove challenging to clinicians. The purpose was to review the scope of lesions affecting the broad ligament. A literature review was conducted. A Medline search was performed using the terms broad ligament, mesosalpinx, and mesovarium. A review of the scope of broad ligament lesions is presented to assist in developing a differential diagnosis if a patient with such a lesion is encountered.
Topics: Adnexal Diseases; Broad Ligament; Diagnosis, Differential; Female; Humans; Leiomyoma; Uterine Neoplasms
PubMed: 26140828
DOI: 10.1016/j.jmig.2015.06.019 -
Journal of Minimally Invasive Gynecology Jul 2022
Topics: Broad Ligament; Endometriosis; Female; Humans
PubMed: 35278702
DOI: 10.1016/j.jmig.2022.03.002 -
Journal of Obstetrics and Gynaecology :... May 2022
Review
Topics: Broad Ligament; Female; Humans; Laparoscopy; Pregnancy; Pregnancy, Ectopic
PubMed: 34569429
DOI: 10.1080/01443615.2021.1958767 -
Journal of Clinical Ultrasound : JCU Jan 2022A 33-year-old woman of giant broad ligament leiomyoma with myxoid degeneration was misdiagnosed as ovarian tumor. The patient underwent a transabdominal myomectomy and... (Review)
Review
A 33-year-old woman of giant broad ligament leiomyoma with myxoid degeneration was misdiagnosed as ovarian tumor. The patient underwent a transabdominal myomectomy and developed a pelvic infection after operation diagnosed with contrast-enhanced ultrasound. She was cured and ultimately discharged after symptomatic treatment. Only 21 cases of giant broad ligament leiomyomas with a diameter larger than 12 cm were included. The present systematic review aimed to increase awareness of the clinical characteristics and treatment methods of giant broad ligament leiomyoma, and reduce the rates of misdiagnosis and postoperative complications.
Topics: Adult; Broad Ligament; Diagnosis, Differential; Female; Humans; Leiomyoma; Postoperative Complications; Uterine Neoplasms
PubMed: 34647631
DOI: 10.1002/jcu.23081 -
Medicine Sep 2018Solitary fibrous tumors (SFTs) are uncommon mesenchymal neoplasms and are particularly rare in the female genital tract. Doege-Potter syndrome is a paraneoplastic... (Review)
Review
INTRODUCTION
Solitary fibrous tumors (SFTs) are uncommon mesenchymal neoplasms and are particularly rare in the female genital tract. Doege-Potter syndrome is a paraneoplastic syndrome involving SFT-associated hypoglycemia. We report, for the first time, on a broad ligament SFT with Doege-Potter syndrome; additionally, we review 30 cases of women with SFTs reported in the literature.
PATIENT CONCERNS
A 37-year-old woman who presented with life-threatening hypoglycemia and a pelvic mass (16 × 15 × 15 cm).
DIAGNOSES
The patient was diagnosed with broad ligament SFT with Doege-Potter syndrome.
INTERVENTIONS
Tumor resection, sub-extensive hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy were performed, and 6 cycles of adjuvant chemotherapy were administered.
OUTCOMES
Serum glucose levels returned to normal as soon as the tumor was resected. Forty-3 months after operation, there was recurrence in the posterior peritoneal tissues. She underwent tumor resection and has remained tumor-free 28 months after this excision.
CONCLUSION
Even though it is extremely rare, SFT should be quickly identified to prevent undue treatment delay and avoid unnecessary examination; surgery and long-term follow-up are recommended. SFT can be considered a highly invasive cancer, and intraoperative bleeding may occur. Although no correlation between adjuvant therapy and improved prognosis was found, further studies are required because of the small number of cases reported to date.
Topics: Adnexal Diseases; Adult; Broad Ligament; Chemotherapy, Adjuvant; Female; Humans; Hypoglycemia; Hysterectomy; Lymph Node Excision; Ovariectomy; Paraneoplastic Syndromes; Salpingectomy; Solitary Fibrous Tumors
PubMed: 30278559
DOI: 10.1097/MD.0000000000012564 -
Clinical Anatomy (New York, N.Y.) Apr 2004The broad ligament is a double fold of peritoneum forming a mesentery for the human female genital tract. We investigated the anatomy of the broad ligament in different... (Review)
Review
The broad ligament is a double fold of peritoneum forming a mesentery for the human female genital tract. We investigated the anatomy of the broad ligament in different species and its hormonal regulation to determine if it had a role in gonadal positioning. The medical and veterinary literature was reviewed for descriptions of broad ligament anatomy and development. In addition, four adult female rats were dissected to compare the macroscopic anatomy of the broad ligament with any homologous structures in the male (n = 2). Detailed review was made of human males with persistent Müllerian duct syndrome (PMDS) and of bovine freemartin calves to determine the effect of abnormal hormonal environments on broad ligament development. Human and veterinary texts show variable broad ligament development between species, most being consistent with the size and shape of the uterus and uterine tubes. The broad ligament in adult female rats is a simple peritoneal fold and is homologous with the mesentery of the testis and vas deferens in males. Patients with PMDS and bovine freemartins have a broad ligament with intermediate anatomy. In PMDS the broad ligament is elongated and narrow, and not attached to the pelvic wall. The broad ligament is the mesentery of the genital ducts, and its anatomy varies with the degree of Müllerian duct fusion. The absence of a human male homologue is unusual, as the genital mesentery persists in male rodents. Apparent lack of a male homologue in the human may relate to obliteration of the processus vaginalis. The variable development of the broad ligament in pathological conditions is consistent with a role for steroid hormones in its development.
Topics: Adult; Animals; Anti-Mullerian Hormone; Broad Ligament; Carnivora; Cattle; Equidae; Female; Freemartinism; Glycoproteins; Gonadal Hormones; Humans; Male; Mullerian Ducts; Peritoneum; Rats; Ruminants; Swine; Testicular Hormones
PubMed: 15042574
DOI: 10.1002/ca.10173 -
Journal of Minimally Invasive Gynecology Aug 2023
Topics: Female; Humans; Laparoscopy; Intestinal Obstruction; Internal Hernia; Broad Ligament; Hernia
PubMed: 37094705
DOI: 10.1016/j.jmig.2023.04.007 -
International Journal of Gynecological... Sep 2017Angiomyofibroblastoma (AMF) is a distinctive, rare, benign mesenchymal tumor that often occurs in the lower genital region of women. The most commonly reported location... (Review)
Review
Angiomyofibroblastoma (AMF) is a distinctive, rare, benign mesenchymal tumor that often occurs in the lower genital region of women. The most commonly reported location of an AMF is in the vulvovaginal area. We describe a rare case of an AMF located in the broad ligament in a 47-yr-old woman. The patient experienced menorrhagia, dysmenorrhea, and subsequent menstrual spotting. She sought help at the National Cheng Kung University Hospital. Ultrasonography showed an echo-complex mass in the left adnexal area. The patient underwent laparoscopic surgery to remove the soft tissue mass located in the left broad ligament. The final pathology of the mass was reported as an AMF. We reviewed all of the AMF cases reported in the English-language literature found in Pubmed. This case is the first of AMF located in the broad ligament.
Topics: Angiomyoma; Broad Ligament; Female; Genital Neoplasms, Female; Humans; Laparoscopy; Middle Aged; Neoplasms, Muscle Tissue; Ultrasonography
PubMed: 28800578
DOI: 10.1097/PGP.0000000000000356