A Case of Greater and Lesser Transomental Sac Hernia Affected an 84-year-old Woman

Abstract

An 84-year-old woman presented to our emergency clinic with epigastric pain and vomiting. Abdominal plain X-ray showed gastric bubbles that were compressed to the left lateral side and a dilated small intestine in the region of the gastric lesser curvature. A plain CT scan showed a small intestine forming a niveau in the region surrounded by the stomach and the liver. Strangulated ileus was suspected, and emergency surgery was performed on the same day. The dilated small intestine had entered the omental bursa through a defect in the greater omentum. In addition, the small intestine prolapsed from the dorsal surface of the stomach through a defect in the lesser omentum and was thereafter strangulated. Based on these findings, the final diagnosis of the greater and lesser transomental sac hernia was made. The lesser omentum was incised to reduce the strangulation. The wall of the small intestine was not resected because it improved with time.

We report a case of an elderly patient with a greater and lesser transomental sac hernia with some discussion of the literature.