A case of intra-abdominal bleeding from injured round ligament after inguinal hernia repair associated with endometriosis

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  • 鼠径部子宮内膜症を伴う鼠径ヘルニア術後の子宮円靱帯断裂腹腔内出血の1例
  • 症例 鼠径部子宮内膜症を伴う鼠径ヘルニア術後の子宮円靱帯断裂腹腔内出血の1例
  • ショウレイ ソケイブ シキュウ ナイマクショウ オ トモナウ ソケイ ヘルニア ジュツゴ ノ シキュウエン ジンタイダンレツフクコウ ナイシュッケツ ノ 1レイ

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Abstract

A 32-year-old woman treated 3 years ago for endometriosis presented with right inguinal pain during menstruation. We diagnosed it as Nuck duct hydrocele related to endometriosis. She underwent surgery in March 2010. The right inguinal hernia sac was opened, and its orifice continued to the abdominal cavity. The hernia sac with spots of hemosiderin confirmed endometriosis. The hernia sac was highly ligated and removed with the round ligament of the inguinal canal. She was complained of abdominal pain and anemia at 1 post operative day. Computed tomography (CT) showed intra-abdominal bleeding, and laparoscopic surgery was performed emergently. The bleeding was found in the injured right round ligament which was fragile with inflammation from the endometriosis. The bleeding was stopped using a bipolar electric knife and surgical clip. The second operative course was uneventful. It was considered that the round ligament in inguinal hernia repair should be operated on as gently as possible in patients with endometriosis.

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