探讨子宫阔韧带疝致绞窄性肠梗阻的CT影像学表现。

回顾性分析2022年12月23日济宁市第一人民医院胃肠外科收治的1例子宫阔韧带疝合并绞窄性肠梗阻患者的CT及手术资料，并复习相关文献。

患者女性，69岁，因腹痛1 d入院，疼痛呈持续性发作，间歇性加重，伴腹胀、恶心、呕吐，呕吐物为非血性胃内容物，并停止排气排便。行腹部CT平扫示下腹部分小肠聚集，疝口位于子宫左侧、子宫圆韧带前上方，远端回肠经子宫左后向前下疝入，疝口区可见疝入肠袢呈"鸟嘴状"及邻近被牵拉呈条状的膀胱，冠状位显示疝入部分肠袢僵硬呈"C"型，肠壁稍厚，相应系膜水肿、静脉扩张呈毛刷状，提示腹内疝并肠梗阻，经手术治疗证实为子宫阔韧带疝。

腹内疝导致的绞窄性肠梗阻，术前诊断较为困难，多排螺旋CT对子宫阔韧带疝合并肠梗阻及肠缺血的诊断有重要提示价值。

To explore the CT imaging findings of strangulated intestinal obstruction caused by uterine broad ligament hernia.

A retrospective analysis was conducted on the CT and surgical data of a patient with uterine broad ligament hernia combined with strangulation intestinal obstruction admitted to the Department of Gastrointestinal Surgery of Jining NO.1 People′s Hospital on December 23, 2022, and the relevant literature was reviewed.

A 69-year-old female patient presented with abdominal pain for 1 day. The pain was persistent with intermittent exacerbations, accompanied by abdominal distension, nausea, vomiting of non-bloody gastric contents, and cessation of flatus and defecation. Plain abdominal CT scan revealed clustered small bowel loops in the lower abdomen. The hernia orifice was located anterior-superior to the left round ligament of the uterus. Distal ileal herniated into the uterus from the left posteriorly to the front and downward. The herniated bowel loop at the hernia orifice exhibited a beak sign, and the adjacent bladder was stretched into a linear shape. Coronal images showed rigid, C-shaped herniated bowel loops with slightly thickened walls, associated mesenteric edema, and brush-like venous dilation, suggesting internal hernia with intestinal obstruction. Surgical intervention confirmed the diagnosis of broad ligament hernia.

Preoperative diagnosis of strangulated intestinal obstruction caused by internal abdominal hernia is challenging. Multi-row spiral computed tomography provides significant diagnostic clues for uterine broad ligament hernia complicated by intestinal obstruction and intestinal ischemia.