Clinical Study of Strangulated Obstruction Caused by Transomental Hernia

Abstract

Transomental hernia is a rare disease, since it is a type of intra-abdominal hernia that forms as a result of incarceration through an abdominal greater omental hiatus. This disease lacks specific physical features, making its preoperative diagnosis difficult. Between 2009 and 2016, we encountered ten cases of transomental hernia in which MD-CT was helpful for preoperative diagnosis. The patients ranged in age from 58 to 83 years old (average：67 years old), and the male-to-female ratio was 6 to 4. The preoperative diagnoses were transomental hernia in 6 and intra-abdominal hernia in 4, based on MD-CT findings. MD-CT showed a dilated small intestine on the ventral side of the ascending colon and the transverse colon through the omental hiatus, a closed loop, and the convergence of a mesentery or the small intestine. The possibility of transomental hernia should be considered when treating patients with an obstruction who have no history of a laparotomy. MD-CT with multiplanar reconstruction (MPR) is useful for the preoperative diagnosis of trans-omental hernia.