Abstract
Transomental hernia is an exceedingly rare disease and only 45 cases have been reported in Japan between 1953 and 1987. The present patient was a 68-year-old woman. The clinical and X-ray diagnosis was acute small bowel obstruction. At surgery, an ileal loop was found to have herniated into the lesser sac space through a hole in the great omentum and strangulated. Consequently the upper small bowel was markedly distended and volvulus was found in the jejunum, which was also strangulated. Accordingly, these two loops were resected and end-to-end anastomosis was done. The postoperative course was uneventful and the patient was discharged on the 32nd day. The authors discuss the size and origin of the hole, the herniated organ, and the operative procedure, based mainly on 45 collected case reports, and place special emphasis on the importance of preoperative diagnosis and early surgical intervention.
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