Displacement of the transverse colon is a highly specific computed tomography finding for the preoperative diagnosis of a transomental hernia

Ito, Ryota; Mori, Kazuhiko; Minamimura, Keisuke; Hirata, Toru; Kobayashi, Takashi; Kawasaki, Seiji

doi:10.1007/s11604-019-00851-1

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…A transomental hernia shows finding of small bowel obstruction. In our two cases, transverse colon loops were located posterior to dilated intestinal loops, as previously reported [7]. Identification of intestinal localization was easier by using the CE-CT. That was why we used the CE-CT as the initial imaging study for case 2.…”

Section: Discussionsupporting

confidence: 86%

Laparoscopic surgery for two patients with strangulated transomental hernias

et al. 2020

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Background: Transomental hernias are a rare type of internal hernia. We report two cases of successful cases of laparoscopic repair. One required laparotomy due to concern for intestinal viability. Case presentation: The first patient was a 67-year-old man who presented with abdominal pain and vomiting. He had no history of laparotomy or abdominal injury. Computed tomography suggested small bowel obstruction and possible intestinal strangulation. Emergent laparoscopy found approximately 200 cm of small bowel was strangulated around the greater omentum. The strangulation was released laparoscopically, but because of the color of the strangulated bowel, laparotomy was performed to evaluate viability. The involved portion of intestine was not resected. The patient experienced transient postoperative paralytic ileus and was discharged on postoperative day 14. The second patient was a 56-year-old man who presented with abdominal pain. Abdominal computed tomography revealed dilatation of the small intestine and a closed loop suggesting ileus due to intestinal strangulation. An emergency laparoscopy found a transomental hernia, and the strangulation was released laparoscopically. Recovery was uneventful, and the patient was discharged on postoperative day 6. Conclusion: Transomental hernia can be successfully treated laparoscopically. In cases where bowel viability is a concern, laparotomy should not be hesitated.

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Section: Discussionsupporting

confidence: 86%

Laparoscopic surgery for two patients with strangulated transomental hernias

et al. 2020

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“…Despite the high mortality of transomental hernias (30%) [2,3], the definitive diagnosis is usually established intraoperatively, as in our case [11]. Ito et al [12] recently reported the clinical utility of the CT finding of displacement of the transverse colon posterior to obstructed intestinal loops, which distinguishes transomental hernia from other types of small bowel obstruction.…”

Section: Discussionmentioning

confidence: 84%

Development of transomental hernia shortly after laparoscopic colonic surgery: a case report

et al. 2020

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Background: A transomental hernia is defined as bowel invagination into an abnormal hiatus of the omentum. It is a rare type of internal hernia that is sometimes lethal. We herein report a case of a transomental hernia developing shortly after laparoscopic sigmoidectomy. Case presentation: A 71-year-old man underwent laparoscopic sigmoidectomy. He was admitted to our hospital because of abdominal pain and nausea on postoperative day 12. Laboratory investigation showed increased levels of inflammatory markers. Abdominal computed tomography showed a closed loop and mesenteric edema of the small intestine with ascites. We performed an emergency operation under the diagnosis of strangulated bowel obstruction. Operative findings showed internal herniation of strangulated ileal loops through a defect of the omentum with hemorrhagic ascites. The incarcerated small bowel was resected and reconstructed because the ischemic change was irreversible after the reduction. We partially resected the omentum that had formed the defect. The patient's postoperative progress was good, and he was discharged on postoperative day 8. Conclusions: Almost all internal hernias after intestinal surgery are mesenteric hernias; however, we should bear in mind that the more lethal transomental hernia is also possible. Therefore, immediate surgical exploration should be performed in a timely manner for internal hernias, especially for patients with early-onset symptoms after laparoscopic intestinal surgery.

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Computed tomography diagnosis of transomental hernia

Inoue

Furukawa

2019

Jpn J Radiol

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Displacement of the transverse colon is a highly specific computed tomography finding for the preoperative diagnosis of a transomental hernia

Cited by 5 publications

References 14 publications

Laparoscopic surgery for two patients with strangulated transomental hernias

Laparoscopic surgery for two patients with strangulated transomental hernias

Development of transomental hernia shortly after laparoscopic colonic surgery: a case report

Computed tomography diagnosis of transomental hernia

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