Abstract
Transomental hernia, formed by an incarceration through an abnormal hiatus of the greater omentum, is relatively rare ; it requires early diagnosis and surgical treatment. Since the small intestine is located behind the omentum, it usually incarcerates into the hernial opening from the back to the front. We treated a patient with a transomental hernia in which the jejunum had atypically incarcerated from the front to the back. A 66-year-old man complained of nausea and vomiting and was diagnosed as having a bowel obstruction. He had undergone an operation due to acute appendicitis over thirty years prior. After admission, he developed abdominal fullness and pain in the right upper abdomen. Conservative treatment using a long tube was tried to no effect. Thus, surgery was perfomed. During surgery, a 20-cm necrosed portion of the jejunum about 140 cm distal from the ligament of Treitz was found to have become incarcerated from the front to the back via an abnormal hiatus of the right side of the omentum. A The necrotic intestine was resected ; the omentum involved in the abnormal hiatus was removed. The postoperative course was uneventful. To the best of our knowledge, in Japan, only one case other than the present case has been reported.
