A Case of Transomental Hernia in A 95-Year-old Woman

Tomoaki Takada¹⁾²⁾, Hideaki Yoshida¹⁾, Morio Tsukada¹⁾, Shunichi Okushiba²⁾ and Hiroyuki Katoh²⁾

¹⁾Department of Surgery, Yoichi Kyokai Hospital ²⁾Second Department of Surgery, Hokkaido University School Medicine

A 95-year-old woman diagnosed with a bowel obstruction was referred to our department for abdominal pain and vomiting. She had no history of laparotomy. Two smooth stenosis of the small intestine was detected by long-tube enterogram, showing 1 small intestinal loop strangulated through an abnormal defect. Computed tomography showed ascites, a strangulated small intestinal-loop, and a mesenterium of the anal side. Laparotomy was conduced for a diagnosis of internal hernia due to an abnormal defect. Surgery showed the small intestine had herniated through the abdominal hiatus of the greater omentum. The strangulated intestinal loop was released and the postoperative course is good. Long-tube enterography and CT were helpful in the preoperative diagnosis. In the absence of previous surgery, the differential diagnosis of intestinal obstruction must include internal hernia and early diagnosis is important. This woman is, to our knowledge, the oldest person in Japan to have been operated on for transomental hernia.

Key words
internal hernia, transomental hernia, old age

Reprint requests
Tomoaki Takada Department of Surgery, Yoichi Kyokai Hospital 85 Kurokawa-cho, Yoichi-cho, Yoichi-gun Hokkaido, 046-0003 JAPAN

Accepted
October 31, 2000

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