title: A spontaneous strangulated transomental hernia: Prospective and retrospective multi-detector computed tomography findings.
abstract: Transomental hernias are among the rarest type of all internal hernias which overall account for less than 6% of small bowel obstructions. Most transomental hernias occurring in adults are either iatrogenic or post-traumatic. More rarely, a spontaneous herniation of small bowel loops may result from senile atrophy of the omentum. We report a case of an 86-year-old male who presented with signs and symptoms of small bowel obstruction but had no past surgical or traumatic abdominal history. At contrast-enhanced multi-detector row computed tomography (CT), a cluster of fluid-filled dilated small bowel loops could be appreciated in the left flank, with associated signs of bowel wall ischemia. Swirling of the mesenteric vessels could also be appreciated and CT findings were prospectively considered consistent with a strangulated small bowel volvulus. At laparotomy, no derotation had to be performed but up to 100 cm of gangrenous small bowel loops had to be resected because of a transomental hernia through a small defect in the left part of the greater omentum. Retrospective reading of CT images was performed and findings suggestive of transomental herniation could then be appreciated.
authors.affiliation: Luigi Camera, Angela De Gennaro, Margaret Longobardi, Emanuela Calabrese, Marco Salvatore, Department of Radiology, University "Federico II", 80131 Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Camera
authors.affiliation: Luigi Camera, Angela De Gennaro, Margaret Longobardi, Emanuela Calabrese, Marco Salvatore, Department of Radiology, University "Federico II", 80131 Naples, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: De Gennaro
authors.affiliation: Luigi Camera, Angela De Gennaro, Margaret Longobardi, Emanuela Calabrese, Marco Salvatore, Department of Radiology, University "Federico II", 80131 Naples, Italy.
authors.forename: Margaret
authors.initials: M
authors.lastname: Longobardi
authors.affiliation: Luigi Camera, Angela De Gennaro, Margaret Longobardi, Emanuela Calabrese, Marco Salvatore, Department of Radiology, University "Federico II", 80131 Naples, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Masone
authors.affiliation: Luigi Camera, Angela De Gennaro, Margaret Longobardi, Emanuela Calabrese, Marco Salvatore, Department of Radiology, University "Federico II", 80131 Naples, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Calabrese
authors.affiliation: Luigi Camera, Angela De Gennaro, Margaret Longobardi, Emanuela Calabrese, Marco Salvatore, Department of Radiology, University "Federico II", 80131 Naples, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Del Vecchio
authors.affiliation: Luigi Camera, Angela De Gennaro, Margaret Longobardi, Emanuela Calabrese, Marco Salvatore, Department of Radiology, University "Federico II", 80131 Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Persico
authors.affiliation: Luigi Camera, Angela De Gennaro, Margaret Longobardi, Emanuela Calabrese, Marco Salvatore, Department of Radiology, University "Federico II", 80131 Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Salvatore
keywords: Internal hernias; Multi-detector row computed tomography; Small bowel obstruction; Strangulation; Transomental hernia