2016 Volume 36 Issue 3 Pages 687-690
A 41-year-old man visited our hospital with right lower abdominal pain. He had tenderness in the right lower quadrant of the abdomen, slight bulging in the right groin region and swelling of the right scrotum. Blood studies revealed an elevated leukocyte count and C reactive protein level. Abdominal CT examination showed a whorl-like structure which was just below the umbilical region and distally toward a high-density area connecting to the right groin hernia. Under a diagnosis of secondary omental torsion caused by an incarcerated right groin hernia, emergency surgery was performed. During surgery, an indirect groin hernia was found. The greater omentum had not entered the hernia sac and was twisted one and a half times in the umbilical region. Because the distal side of the omentum was necrotic, the necrotic omentum was resected at its normal site. Repair of the right groin hernia by the modified Kugel procedure was performed. The postoperative course was good and the patient was discharged on postoperative day 6. In this paper, the 39 cases of secondary omental torsion caused by groin hernia in the Japanese literature were analyzed.