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Background A hematoma that gradually increases over a chronic course of months or longer is defined as a chronic expanding hematoma (CEH). CEHs often develop in the limbs and on body surfaces that are susceptible to external stimuli. CEHs in the intrathoracic or intraperitoneal organs are uncommon, with liver CEHs being particularly rare worldwide. Case presentation A 57-year-old woman was previously diagnosed with a giant cyst in the right liver lobe, with a longer axis of approximately 15 cm. Abdominal ultrasonography findings suggested a complex cyst, and she was referred to our hospital for further inspection. Although CEH was suspected, it was difficult to exclude malignant diseases such as intraductal papillary neoplasm of the bile duct and cystadenocarcinoma. There was a possibility of malignant disease and the exclusion of surrounding organs due to tumor growth. Therefore, a right hepatectomy was performed. Pathological examination revealed a pseudocyst containing a clot, which was consistent with CEH. Conclusions CEH rarely occurs in the liver; however, it is necessary to consider CEH when a slow-growing hepatic mass that shows a mosaic pattern on magnetic resonance imaging is found.

Introduction: Transomental hernia (TOH), a type of intra-abdominal hernia formed as a result of incarceration through abdominal greater omental hiatus, is a rare disease that lacks specific physical features, which makes its preoperative diagnosis difficult. This study aims the clinical characteristics and radiological findings of 15 cases of TOH. Methods: From 2009 to 2021, we encountered 15 cases of TOH in which multi-detector row computed tomography (MD-CT) with multiplanar reconstruction (MPR) was helpful for the preoperative diagnosis. We performed a clinical study of patients with TOH. Results: The average age of the 15 patients (male, n=9; female, n=6) was 73 years (range, 58-91 years). The preoperative diagnosis, based on MD-CT, was TOH in 11 patients and internal hernia in 4 patients. The preoperative diagnosis of TOH was confirmed in 11 of 15 patients (73%). MD-CT showed dilatation of the small intestine on the ventral side of the ascending colon and the descending colon through the omental hiatus, closed loop, and the convergence of the mesentery or small intestine. Conclusion: The possibility of TOH should be considered when treating patients with obstruction who have no history of laparotomy. MD-CT with MPR is useful for the preoperative diagnosis of TOH.

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