title: Small-bowel intestinal obstruction caused by an unusual internal hernia.
abstract: We report a rare case of transomental small-bowel herniation in a 91-year-old lady who presented with central abdominal pain and mild distension. Urgent abdominal computed tomography (CT) showed a segment of dilated ileum with features suggestive of strangulation. Emergency exploration revealed a segment of congested small-bowel loop herniated through a defect over the greater omentum. Reduction of the bowel loops and division of the omental defect was performed without the need for bowel resection. The patient made an uneventful recovery. We discuss the value of CT scan and highlight the importance of recognizing this rare cause of small-bowel obstruction.
authors.affiliation: Department of Surgery, North District Hospital, New Territories East Cluster, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
authors.forename: Jimmy C M
authors.initials: JC
authors.lastname: Li
authors.forename: David W
authors.initials: DW
authors.lastname: Chu
authors.forename: Danny W H
authors.initials: DW
authors.lastname: Lee
authors.forename: Angus C W
authors.initials: AC
authors.lastname: Chan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006547:Hernia / Q000150:complications*; D006801:Humans; D007077:Ileal Diseases / Q000150:complications*; D007415:Intestinal Obstruction / Q000209:etiology*; D007421:Intestine, Small; D009852:Omentum