Small bowel obstruction- a surprise.
Trans - omental hernia is very rare, accounting to 1-4% of all internal hernias which is an unusual cause of small bowel obstruction. Here we present a case report of a small bowel obstruction in a female due to trans - omental hernia presenting with central abdominal pain, distension and bilious vomiting. She had no previous history of trauma, surgery. Plain X-ray abdomen erect showed multiple air fluid levels with dilated small bowel loops. Emergency laparotomy revealed a segment of congested small bowel loop (ileum) through a defect in greater omentum. On table the herniated bowel loop was reduced and the defect in greater omentum was closed primarily. There was no necessity for bowel resection as it regained normal colour after reduction. Postoperative period was uneventful with complete resolution of symptoms. This case is presented for its rarity and its importance in clinical differential diagnosis of acute abdomen due to small bowel obstruction.
Post Graduate, Department of General Surgery, Mahatma Gandhi medical college and Research Institute , Pondicherry, India .
Jeffrey Daniel
JD
Mathew
Professor, Department of General Surgery, Mahatma Gandhi medical college and Research Institute , Pondicherry, India .
Ganesh Babu
GB
Cp
Assistant Professor, Department of General Surgery, Mahatma Gandhi medical college and Research Institute , Pondicherry, India .
Balachandar
B
M
Professor, Department of General Surgery, Mahatma Gandhi medical college and Research Institute , Pondicherry, India .
Ramanathan
R
M
Greater omentum; Internal hernia; Small bowel obstruction