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Case Report
Spontaneous transomental hernia: An interesting intraoperative cause of intestinal obstruction
1 Fellow West African College of Surgeons, FWACS (Consultant General Surgeon), Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
2 Fellow West African College of Surgeons FWACS, FCIS, MPH, Consultant General Surgeon, Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
3 Member West African College of Surgeons, MWACS, Senior Registrar, Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
4 Junior Registrar, Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
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Onyeyirichi Otuu
General Surgery Unit, Department of Surgery, Alex-Ekwueme Federal Teaching Hospital Abakaliki, Ebonyi State,
Nigeria
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Article ID: 100087Z12OO2021
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How to cite this article
Otuu O, Eni EU, Nweke OO, Enweremadu CK. Spontaneous transomental hernia: An interesting intraoperative cause of intestinal obstruction. J Case Rep Images Surg 2021;7:100087Z12OO2021.ABSTRACT
Introduction: Transomental hernia (TOH) is the rarest form of internal hernias (IHs) accounting for approximately 4%. They can occur spontaneously through the greater or lesser omentum as a result of senile atrophy, trauma, or inflammation.
Case Report: A 56-year-old male patient presented to the emergency department with sudden onset of colicky abdominal pain, vomiting, and constipation of 12 hours duration. There was associated epigastric/periumbilical tenderness with hyperactive bowel sounds. A plain film of the abdomen demonstrated dilated small bowel loops with an air-fluid level in the epigastrium and on the right upper quadrant of the abdomen. A diagnosis of acute intestinal obstruction from small bowel volvulus was made and the patient underwent emergency exploratory laparotomy. Operative exploration showed a TOH through a defect on the inferior edge of the right side of the greater omentum measuring 5 cm in diameter and strangling a 30 cm loop of ileum. The small bowel looked ischemic and congested but returned back to normal coloration after reduction. The hernia defect was closed with interrupted absorbable sutures after excision of the fibrotic distal edge. The patient had an uneventful postoperative recovery.
Conclusion: Surgeons should maintain a high index of clinical suspicion to reduce the risk of complications from IHs such as a TOH.
Keywords: Internal hernia, Intestinal obstruction, Transomental hernia
SUPPORTING INFORMATION
Author Contributions
Onyeyirichi Otuu - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Uche Emmanuel Eni - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Obinna Okah Nweke - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Chidi Kingsley Enweremadu - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Onyeyirichi Otuu et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
