A CASE OF TRANSOMENTAL LESSER SAC HERNIA WHICH WAS DIAGNOSED PREOPERATIVELY

Abstract

A 22-year-old male was referred to the hospital by a nearby practioner because of prolonged ileus symptom against conservative therapy. Simple abdominal X-ray film and upper gastrointestinal series showed an intestinal gas shadow and extragastric compression on the lesser curvature of the stomach, and the interruption at the duodenum was also admitted. Abdominal CT revealed intestinal loop located in the lesser sac. The patient was diagnosed as transomental lesser sac hernia associated with bowel obstraction, and then emergency operation was performed. At surgey, a jejunal loop was found to have herniated into the lesser sac space through a hiatus in the greater omentum, and lightly strangurated. The jejunal loop was taxised and the hiatus was closed. Transomental lesser sac hernia is a rare disease and 38 cases including this case have been reported in the Japanese literature to date. Preoperative diagnosis of this disease is very difficult and in the previous Japanese reports, only 4 cases were successfully diagnosed.