Abstract
A transomental hernia is rare, but it can lead to a strangulation ileus. We reported a case of strangulated obstruction caused by a type B transomental hernia (Yamguchi's classification). A 39-year-old woman with upper abdominal pain was diagnosed as having a bowel obstruction and was referred to our department. She had no history of previous laparotomy. Abdominal computed tomography showed massive ascites and marked dilatation of the small intestine. An emergency operation was performed since a strangulated ileus was suspected. The greater omentum exhibited remarkable thinning and atrophy, forming many hiatuses. The small intestine had incarcerated via the omental bursa, exhibiting a type B transomental hernia (Yamaguchi's classification).
The strangulated intestinal loop was released, and the affecting greater omentum was resected. The postoperative course was unremarkable, and the patient was discharged on hospital day 12. The differential diagnosis of intestinal obstruction must include incarceration by a transomental hernia, especially in the absence of previous surgery. This is the first case of a type B transomental hernia (Yamaguchi's classification) reported in Japan.
