A Case Report of a Spontaneous Incarcerated Transomental Hernia through a Defect in Gastrocolic Ligament with a Review of Domestic Literature on Transomental Internal Hernia

Abstract

Incarcerated transomental hernias through a defect in the gastrocolic ligament are extremely rare. A woman aged 51who had upper abdominal pain for 5 hours was admitted to the emergency department of Jeju National UniversityHospital. Abdominal computed tomography images revealed a protrusion of a jejunal segment into a lesser sac (omentalbursa) with mild wall thickening, decreased perfusion of bowel wall and perivascular fatty infiltrations in its mesentery.These findings suggested an incarcerated transomental hernia into the lesser sac (omental bursa). She underwent adiagnostic laparoscopy immediately. On the operative finding, there was a defect about 4 cm long in gastrocolic ligamentand the jejunal segment which was about 60 cm long and its mesentery were herniated through the defect. A reductionof the jejunal segment and repair of the defect were totally done via laparoscopy. She was discharged on postoperativeday 3 uneventfully. Herein we reports about an experience of a spontaneous incarcerated transomental hernia of smallintestine through a defect in gastrocolic ligament and its successful laparoscopic surgical treatment with a review ofdomestic literatures.