Characteristics and Associated Risk Factors of Broad Ligament Hernia: A Systematic Review

Kelsey Dowers; Sabrina Costantini; Michael J. Montalbano; Vasilis Paraschos; Ewarld G. Marshall; Marios Loukas

doi:10.12659/MSM.946710

24 January 2025 : Review article

Characteristics and Associated Risk Factors of Broad Ligament Hernia: A Systematic Review

Kelsey Dowers

^12BCDEF, Sabrina Costantini^3BCDEF, Michael J. Montalbano

^3BCDEF, Vasilis Paraschos^4BCDEF, Ewarld G. Marshall^5BCDEF, Marios Loukas^3567ADE*

DOI: 10.12659/MSM.946710

Med Sci Monit 2025; 31:e946710

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Table 1 Patient characteristics, including abdominal surgery history, herniated organ, Hunt’s hernia classification, and Cilley’s hernia classification.

Reference	Age, y	Abdominal surgery history	Time since surgery	Herniated organ	Hunt Classification	Cilley et al Classification
Gray et al (1933) []²⁴	25	Appendectomy	5 Years	Right ovary and fallopian tube	Hernia sac	Type 2
Finlaison (1946) []²⁵	N/A	Appendectomy	18 Months	Ileum	Pouch	Type 1
Ishihara et al (1993) []²⁶	40	Appendectomy	Unspecified	Ileum	Fenestra	N/A
Kanbur et al (2000) []²⁷	48	2 deliveries		Jejunum	Fenestra	Type 1
Fukuoka et al (2002) []²⁸	47	None		Ileum	Fenestra	N/A
Bailey et al (2006) []²⁹	45	N/A		Distal ileum	Fenestra	N/A
Garcia-Oria et al (2006) []³⁰	43	Unspecified bowel surgery	Unspecified	Terminal ileum	Fenestra	Type 2
Hiraiwa et al (2006) []³¹	28	None		Ileum	Fenestra	N/A
Oladele et al (2006) []³²	45	4 Deliveries		Ileum and transverse colon	Fenestra	Type 1
Agresta et al (2007) []³³	38		7 Years (appendectomy)	Ileum	Fenestra	Type 1
Agresta et al (2007) []³³	55	2 deliveries		Ileum	Fenestra	Type 1
Ferrari et al (2007) []³⁴	35	None		N/A	Fenestra	Type 3
Varela et al (2007) []³⁵	29		Unspecified	Terminal ileum	Fenestra	N/A
Leone et al (2009) []³⁶	36	None		Small bowel	Fenestra	N/A
Demir et al (2010) []³⁷	42	2 Laparoscopic treatment of endometriosis	16 Years; 9 months	Right ovary	Fenestra	Type 1
Langan et al (2010) []³⁸	59	None		Ileum	Fenestra	N/A
Mailleux et al (2010) []³⁹	38	None		Small bowel	Fenestra	Type 2
Brion et al (2011) []⁴⁰	35	None		Small bowel	Fenestra	Type 1
Hassadia et al (2011) []⁴¹	41	None		Bilateral ovaries	Fenestra	N/A
Bangari et al (2012) []⁴²	42	None		Small bowel	Fenestra	Type 1
Marraoui et al (2012) []⁴³	24	None		Small bowel	Fenestra	N/A
Marraoui et al (2012) []⁴³	51		20 Years (tubal ligation)	Ileum	Fenestra	N/A
Ngabou et al (2012) []⁴⁴	42	None		Small bowel	Fenestra	N/A
Quiroga et al (2012) []⁴⁵	74	None		Ileum	Fenestra	Type 1
Bakare et al (2013) []⁴⁶	32	None		Terminal ileum	Hernia sac	N/A
Lo et al (2013) []⁴⁷	31		5 Years (endometriosis excision)	Sigmoid colon	Fenestra	Type 1
El Madi et al (2014) []¹⁹	13 Months	None		Bladder	Fenestra	N/A
Matsunami et al (2014) []⁴⁸	36	Cesarean delivery	Unspecified	Small bowel	Fenestra	Type 1
Post et al (2014) []⁴⁹	34	None		Ileum	Fenestra	N/A
Post et al (2014) []⁵⁰	45	2 Deliveries		Small bowel	Fenestra	N/A
Cameron et al (2015) []⁵⁰	49		9 Years; 15 years	Small bowel	Fenestra	N/A
Rodrigues et al (2015) []²⁰	47	None		Small bowel	Fenestra	N/A
Otani-Takei et al (2016) []¹⁴	65	Total hysterectomy	15 Years	Small bowel	Fenestra	N/A
Mee KA et al (2017) []⁵¹	31	None		Cecum & ascending colon	Not specified	N/A
Kang et al (2018) []⁵²	32	2 Cesarean deliveries	Not specified	Small bowel	Not specified	N/A
Toolabi et al (2018) []¹⁶	37	Umbilical hernia repair	Unspecified	Small bowel	Fenestra	N/A
Fernandes et al (2019) []¹⁸	35	None		Small bowel	Fenestra	Type 1
Fernandes et al (2019) []¹⁵	43	None		Small bowel	Fenestra	Type 1
Fernandes et al (2019) []¹⁵	51	None		Small bowel	Fenestra	Type 1
Zemour et al (2019) []⁵³	35	Left BLH leading to intestinal resection	1 Year	Terminal ileum	Fenestra	Type 1
Hashimoto et al (2020) []⁵⁴	53	Small bowel obstruction associated with BLH followed by resection of ischemic bowel	10 Years	Ileum	Fenestra	Type 1
Reyes et al (2020) []⁵⁵	70		Unspecified	Small bowel	Fenestra	N/A
Sugishita et al (2020) []⁵⁶	71		Unspecified	Small bowel	Fenestra	N/A
Yu et al (2020) []⁵⁷	52	Cesarean delivery ×2	29 Years, 19 years	Terminal ileum	Hernia sac	N/A
Arif et al (2021) []⁵⁸	62	None		Terminal ileum	Fenestra	N/A
Castro-Ruiz et al (2021) []⁵⁹	33	None		Ileum
MacDonald et al (2021) []²⁵	34	None		Ileum	Fenestra	Type 2
Ohno et al (2021) []⁶⁰	78	None		Sigmoid colon	Fenestra	Type 2
Pascotto et al (2021) []¹⁷	43	Laparoscopic resection of uterine cyst	25 Years	Ileum	Fenestra	Type 3
Rohatgi et al (2021) []¹³	35	Cesarean delivery ×1	10 Days	Small bowel	Fenestra	Type 2
Rohatgi et al (2021) []¹³	42	None		Terminal ileum	Fenestra	Type 2
Takahashi et al (2021) []¹⁸	52	Cesarean delivery ×1	Unspecified	Small bowel	Fenestra	N/A
Agrawal et al (2022) []⁶¹	32	Cesarean delivery ×1	7 Years	Small bowel	Fenestra	N/A
Kubota et al (2022) []⁶²	46	None		Small bowel	Fenestra	N/A
Marzouk et al (2022) []⁶³	71	None		Small bowel	Fenestra	Type 1
Nandi et al (2022) []⁶⁴	48	None		Terminal ileum	Fenestra	N/A
Atileh et al (2023) []⁶⁵	38	Cesarean delivery ×2	Unspecified	Small bowel	Fenestra	N/A
Bouzid et al (2023) []⁶⁶	34	None		Ileum	Fenestra	Type 1
Song et al (2023) []⁶⁷	57	None		Small bowel	Fenestra	Type 1
Zucal & Nebiker (2023) []⁶⁸	44	None		Ileum	Fenestra	Type 1
Karthik N et al (2024) []⁶⁹	42	2 Cesarean deliveries	Not specified	Ileal loops	Not specified	N/A
Pavlidi et al (2023) []⁷⁰	35	None		Small bowel	Fenestra	N/A
: A system categorizing broad ligament hernias (BLH) based on the extent of the defect in the peritoneal folds: fenestra, pouch, and hernia sac types. : A classification system based on the anatomical location of the hernia: type 1 (caudal to the round ligament); type 2 (above the round ligament); and type 3 (between the round ligament and the rest of the broad ligament).

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Characteristics and Associated Risk Factors of Broad Ligament Hernia: A Systematic Review

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