A Case of Small Bowel Obstruction Caused by a Band of the Greater Omentum in a Patient without a History of Laparotomy, that was Effectively Treated by Laparoscopic Surgery

Abstract

A 64-year-old woman was admitted to our hospital complaining of pain in the lower abdomen of sudden onset ; examination revealed tenderness and also rebound tenderness. Blood examination findings were normal, except for an elevated WBC count of 14,480/μl. CT showed caliber change of the small intestine and segmental wall thickening in the same region. Strangulated ileus was strongly suspected and emergency laparoscopic operation was performed. During surgery, the greater omentum was found to be adherent to the peritoneum of the left lower abdominal wall, forming a band strangulating the small intestine. When the band was divided, blood flow and peristalsis of the small intestine were restored. Therefore, after careful observation, we decided not to resect the small intestine. The patient was discharged without any trouble on the 6th postoperative day. We encountered this rare case of strangulated ileus caused by an omental band which was effectively treated with laparoscopy, and report the case with a consideration of previous reports of similar cases. Key words：omentum, internal hernia, strangulated ileus