ArticleJournal of surgical case reports2026
Spontaneous transomental internal hernia causing small bowel obstruction in an elderly patient with a virgin abdomen: a case report.
Article in Journal of surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Internal hernias are a rare cause of small bowel obstruction (SBO), accounting for ~0.5%-5% of cases; transomental hernia represents the rarest subtype, comprising only 1%-4% of internal hernias. We report a 72-year-old man with hypertension but no prior abdominal surgery or trauma who presented with abdominal pain, nausea, and vomiting. Laboratory tests showed leukocytosis; abdominal radiography demonstrated air-fluid levels. Contrast-enhanced computed tomography revealed a collapsed colon, a distinct transition zone between dilated proximal and collapsed distal small bowel loops, and localized mesenteric fat stranding, suggesting internal hernia. After 48 h without improvement on conservative management, exploratory laparotomy revealed a 3-cm circular defect in the greater omentum with a herniated, viable small bowel loop causing closed-loop obstruction. The loop was reduced and the defective omental segment resected without bowel resection. The patient recovered uneventfully and was discharged on postoperative day 3.
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