Radiographic Features of a Strangulated Transomental Hernia

TL;DR

An 82-year-old man with severe abdominal pain was found to have a rare strangulated transomental hernia, requiring emergency surgery to remove damaged bowel tissue.

Contribution

This case highlights the radiographic features of a rare transomental hernia causing bowel obstruction.

Findings

CT imaging showed a closed loop obstruction with anteromedial displacement of the cecum and ascending colon.

Surgery confirmed a gangrenous ileum segment strangulated by a transomental hernia.

Early recognition of radiographic signs is critical to prevent bowel ischemia.

Abstract

This is a case report of an 82-year-old male who presented with intractable and diffuse abdominal pain and had a computed tomography (CT) abdomen showing a closed loop obstruction in the right hemiabdomen with anteromedial displacement of the cecum and ascending colon. Exploratory laparotomy revealed a gangrenous segment of the ileum strangulated by a transomental hernia in the right lower quadrant. The nonviable bowel was resected, and the healthy bowel segments were anastomosed. It is important to correlate the clinical signs of bowel obstruction with radiographic findings of internal hernia to expedite surgical intervention and prevent complications of bowel ischemia.

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