Acute Intestinal Obstruction Revealing an Internal Hernia of the Broad Ligament Following Promontofixation: A Case Report

Internal hernias through the broad ligament are a rare cause of acute intestinal obstruction, often discovered intraoperatively. We report the case of a 75-year-old woman who presented to the emergency department with abdominal pain evolving over three days, associated with vomiting and obstipation (inability to pass stool and flatus). Contrast-enhanced abdominopelvic CT imaging revealed a mechanical small bowel obstruction with a pelvic transition zone, suggesting either an internal hernia of the broad ligament or a postoperative adhesion. Initial medical management was instituted, given the absence of signs of bowel ischemia. This case highlights the importance of considering this rare condition in the differential diagnosis of unexplained bowel obstruction in women, even in the absence of initial signs of severity.