Two Cases of Transomental Hernia in Which the Intestine Could Be Preserved

Abstract

Case 1 was a 45-year-old woman who was transferred to the emergency room with abdominal pain and vomiting. Abdominal computed tomography (CT) revealed intestinal obstruction due to an internal hernia. Emergency laparoscopy was performed, which revealed a transomental hernia. The hernia orifice was opened laparoscopically without intestinal resection. Case 2 was a 41-year-old woman who was transferred to the emergency room with abdominal pain and diarrhea. We initially diagnosed the patient as having enteritis, but an abdominal CT on the following day revealed an internal hernia. Emergency laparotomy was performed and the transomental hernia was released without intestinal resection. Transomental hernias can cause intestinal necrosis and intestinal resection is often required if surgery is not performed early. The presence or absence of intestinal necrosis is related to the number of days after the disease onset and length of the obstructed intestinal tract. If there is no intestinal necrosis and intestinal dilatation is mild, surgery can be performed laparoscopically and early postoperative recovery can be expected. Preoperative diagnosis of transomental hernia is often difficult; therefore, if an internal hernia or strangulated ileus is diagnosed, emergency surgery, including a review laparoscopic surgery, should be considered.