A case of trans-omental hernia: An incarcerated bowel condition detected by computed tomography

A case of trans-omental hernia with strangulated obstruction is reported. A 79-year-old man was admitted to our hospital with mild abdominal pain, fev er and having vomited once. Although signs of peritoneal irritation were no t apparent, preoperative CT with intravenous contrast medium showed locally dilated and thickened loops of proximal small bowel that were poorly enhan ced. This suggested strangulation of the bowel and an emergent laparotomy w as performed. A segment of jejunum had herniated into the gastroomental spa ce through a congenital defect. The incarcerated bowel was resected. The po stoperative course was uneventful except for a subcutaneous abscess. CT wit h intravenous contrast medium is a useful diagnostic tool in the differenti ation of all forms of intestinal obstruction, even when the clinical signs and plain abdominal X-ray are unspecific. Copyright (C) 2000 S. Karger AG, Basel.