Dr. Dan C. Martin's
Clinical Practice is at:
UT Medical Group, Inc.
7945 Wolf River Blvd
Suite 320
Germantown,
TN 38138
Phone (901) 347-8331
Fax (901) 347-8188
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Broad Ligament Pockets and Medial Deviation of the Ureter
Pelvic pockets were noted in the 1920s by Dr. Samson. This may be present since birth or may may occur due to scarring due to endometriosis. Although these are also called Allen Masters syndrome, the Allen Masters syndrome originally described tears due to injuries that occurred to the mother during delivery of an infant. Peritoneal pockets in the broad ligament may have the ureter as their medial border in up to 100% of cases. This appears to be associated with medial displacement in 25% or more of cases.
Medial displacement and prominence may cause misidentification as a uterosacral
ligament. This puts the ureter as increased risk if it is not identified.
Identification is enhanced by tracking the structure toward the sacrum
(uterosacral ligament) or the pelvic brim (ureter). If an apparent
uterosacral ligament goes over the pelvic brim, it is the ureter and not the
uterosacral. Medial displacement of the ureter and a broad ligament pocket are seen on the right side.
Normal position of the ureter with a normal broad ligament are seen on the left.
Figure
at 600 %
Right broad ligament pocket with prominent ureter as medial border of
pocket but in otherwise relatively normal position.