A CASE OF INTESTINAL OBSTRUCTION RESULTING FROM TRANSOMENTAL HERNIA BY ABDOMINAL ADHESION OF THE OMENTUM

Abstract

A 70-year-old man suddenly developed upper abdominal pain after a supper and was seen at the hospital. He had had no previous history of abdominal trauma and abdominal surgery. Plain x-ray films of the abdomen demonstrated multiple air-fluid levels with dilated small bowel loops, suggesting intestinal obstruction. After admittion the patient was treated by intestinal intubation and decompression. Small intestinal series demon-strated a stenosis lesion of the small intestine about 100cm distant from the Treitz ligament. At surgery, a little peritoneal fluid was encountered. Small intestines were dilated and a loop of the small intestine was incar-cerated through the omentum caused by abnormal adhesion of the omentum. The incarcerated area measured 40cm in length. The adhesion of the omentum was resected, the ileus was released, and the operation was finished. Postoperative course was uneventful. The patient was discharged and followed on an ambulant basis. In-testinal obstruction involving the omentum is rarely encountered. In this paper, a rare case of intestinal ob-struction resulting from transomental hernia by abdominal adhesion of the omentum is reported, together with some bibliographical comments.