A Case of a Lesser Omental Hernia with Greater Omental Hypoplasia Found During Close Inspection of Iatrogenic Perforation of the Small Intestine

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 39; no. 6; pp. 1049 - 1052
• Main Authors: Suzuki, Yunosuke, Uda, Hiroaki, Ito, Shoichiro, Miyazaki, Mai, Hayashi, Taizo, Sugitani, Mami, Kato, Koichi, Kataoka, Masato
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 30.09.2019
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.39.1049

A 95-year-old female patient presented to our hospital with loss of appetite and vomiting. She was diagnosed as having small bowel obstruction, but the cause was not immediately apparent. Therefore, she was admitted for further investigation. After 8 days of hospitalization, the symptoms had not improved, so double balloon endoscopy was performed. Endoscopic examination resulted in perforation and thus an emergency operation was needed. On laparotomy, investigation showed aplasia of the major omentum on the left side of the transverse colon, from which the red-closed loop (approximately 50 cm in length) jejunum had become incarcerated in the anomalous defect (approximately 2 cm in diameter) of the lesser omentum. We treated the internal hernia, and found the perforation site 20 cm distal to the ligament of Treitz. We then sutured the perforation site and closed the omental defect, followed by jejunostomy. Because lesser omental hernias are a rare condition, we report herein on our case, and conduct a review of the relevant literature.