A CASE OF LESSER OMENTAL HERNIA WITH MALROTATION -REPORT OF A CASE-

Abstract

Lesser omental hernia is an extremely rare disease. No cases of the disease associated with malrotation like in this case have been reported so far.
A 76-year-old woman was admitted to the hospital because of abdominal pain and distension. Abdominal plain X-rays and CT scan showed increased small intestinal and colonic gas in the right upper abdomen and dilation of the cecum. Serum CEA level was elevated. The abdomen was markedly distended, and abdominal pain was severe so that emergency operation was needed. At laparotomy the cecum was dilated and twisted counterclockwise. A fissure 5cm in length in the lesser omentum was found to be an internal hernia orifice and gastrocolic ligament was lacked. Almost the entire small intestine and right colon were herniated through the fissure from the dorsal side of stomach. The small intestine and colon showed no evidence of necrosis. The fissure was closed simply after repair of malrotation. Transverse colon cancer was also detected, for which partial transverse colectomy and loop colostomy were performed. The patient was discharged from the hospital on 40 POD without any postoperative complications.