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.