Allen-Masters syndrome as a cause of status ileus – case report

Česká verze

Authors: M. Tesař ^1,2; L. Martínek ^1,2 ; O. Kubala ^1,2; L. Tulinský ^1,2 ; P. Ihnát ^1,2
Authors place of work: Chirurgická klinika Fakultní nemocnice Ostrava, Ostrava ¹; Katedra chirurgických oborů, Lekářská fakulta Ostravské univerzity, Ostrava ²
Published in the journal: Rozhl. Chir., 2022, roč. 101, č. 9, s. 456-459.
Category: Kazuistika
doi: https://doi.org/10.33699/PIS.2022.101.9.456–459

Summary

Introduction: Internal hernias are rare and are encountered in a small percentage of cases. The hernia in the broad ligament of uterus (Allen-Masters syndrome) is a unique type of internal hernia which represents only approximately 4% of all internal hernias.

Case report: We present the case of a 39-year-old woman admitted for clinical signs of mechanical bowel obstruction. CT examination revealed a dilated loop of small intestine in the left lower abdomen. The patient underwent laparoscopic surgery with the finding of an incarcerated small bowel loop in the ligamentum latum uteri. Small bowel deliberation and ligament defect suture were performed.

Conclusion: A defect in the ligamentum latum uteri (Allen-Masters syndrome) is a rare diagnosis, usually discovered as an incidental finding in female patients with ileus. This syndrome may explain the vague problems of many patients whose symptoms include dyspareunia, dysmenorrhea, acute and chronic pelvic pain. Allen-Masters syndrome can be diagnosed and successfully managed by laparoscopic approach.

Keywords:

case report – internal hernia – Allen-Masters syndrome – intestinal obstruction

Zdroje

1. Al Otaibi RS, Al Maghrabi HS, Dous, YB, et al. A rare case of small bowel obstruction due to paraduodenal hernia. The American Journal of Case Reports 2019;20 : 1581–1586. doi:10.12659/ AJCR.918403.

2. Cilley R, Poterack K, Lemmer, J, et al. Defects of the broad ligament of the uterus. The American Journal of Gastroenterology 1986;81(5):389–391.

3. Rafique YR, Harvitkara U, Raut V, et al. Broad ligament hernia: Two contrasting ways to a common goal –⁠ two case reports with review of literature. International Journal of Surgery Case Reports 2021;85 : 106198. doi:10.1016/j. ijscr.2021.106198.

4. Hunt, Arthur B. Fenestrae and pouches in the broad ligament as an actual and potential cause of strangulated intra-abdominal hernia. Surg Gynecol Obstet. 1934;58 : 906–913.

5. Allen WM, Masters WH. Traumatic laceration of uterine support; the clinical syndrome and the operative treatment. American Journal of Obstetrics and Gynecology 1955;70(3):500–513. doi:10.1016/0002 -⁠ 9378(55)90344-6.

6. Gupta R, Elakkary E, Sadeket M, et al. Masters Allen syndrome: a review. Digestive Diseases and Sciences 2007;52(8): 1749 –⁠ 1751. doi:10.1007/s10620-006-9237-7.

7. de Brux JA, Demay BC, Bardiauxet M, et al. Recurring pelvic peritonitis. A comment on the Allen-Masters syndrome. American Journal of Obstetrics and Gynecology 1968;102(4):501–505. doi:10.1016/0002 -⁠ 9378(68)90530-9.

8. Lawry EV. Traumatic laceration of uterine supports. Further observations of the Allen-Masters syndrome. American Journal of Obstetrics and Gynecology 1968;101(3):315–321. doi:10.1016/0002 -⁠ 9378(68)90057-4.

9. Chatman DL. Pelvic peritoneal defects and endometriosis: Allen-Masters syndrome revisited. Fertility and Sterility 1981;36(6):751 –⁠ 756. doi:10.1016/s0015-0282(16)45921-2.

10. Haas D, Oppelt P, Shebl O, et al. Allen-Masters syndrome: do the classic risk factors also apply in patients with endometriosis? The Journal of Obstetrics and Gynaecology Research 2013;39(11):1513–1537. doi:10.1111/jog.12093.

11. Varangor J, Granjon A, Chartier M, et al. Syndrome of laceration of the broad ligament. Presse Med. 1959;67(28):1139–1141.