2021 Volume 41 Issue 5 Pages 347-350
A 40-year-old man with no previous history of abdominal surgery, who visited his local clinic complaining of upper abdominal pain, was referred to our hospital with the diagnosis of bowel obstruction. Abdominal CT revealed dilated loops of the small intestine behind the stomach on the side of the lesser curvature, and we suspected internal hernia. Because the patient’s pain worsened progressively after hospitalization, surgery was performed on the day after admission. The small intestine was found to have herniated through a defect in the greater omentum behind the stomach, and also through another defect in the lesser omentum into the abdominal cavity. The bowel segment that had herniated through the defect in the lesser omentum was found to be strangulated and necrotic. The necrotic segment of the small intestine was resected, with closure of the defects in the greater and lesser omentum were performed. A greater and lesser transomental hernia is extremely rare, and we report our case, along with a review of the literature.
