A CASE OF TRANSOMENTAL HERNIA OCCURRED DURING PREGNANCY

Abstract

We experienced a case of strangulated ileus due to transomental hernia in a pregnant woman without previous history of undergoing laparotomy. A 35-year-old woman arrived at the hospital by ambulance because of an upper abdominal pain and vomiting. She was at 19 weeks gestation and her past medical or surgical histories are unremarkable. Abdominal sonography demonstrated markedly dilated intestine and a simple abdominal X-ray film showed some enlarged intestinal gas shadow on the epigastric region. The patient was diagnosed as intestinal obstruction of unknown origin and received conservative therapy for 2 days. But her condition grew worse, then an emergency operation was performed. At surgery, the jejunal loop was found to have herniated into the lesser sac space through a hiatus in the greater omentum, and lightly strangluated. The jejunal loop was reduced and the hiatus was closed. The postoperative course was uneventful. The patient had a normal spontaneous term delivery at our hospital. Transomental hernia is a rare disease, especially intestinal obstruction during pregnancy. For such a patient the importance of early diagnosis and appropriate operation within an adequate time period should be emphasized.