Transomental hernias: Multi-detector row computed tomography findings in 15 clinical cases
DOI:
https://doi.org/10.7577/radopen.5178Keywords:
Small bowel obstruction, Internal hernia, Transomental hernia, Multi-detector row computed tomography, StrangulationAbstract
Introduction: Transomental hernia (TOH), a type of intra-abdominal hernia formed as a result of incarceration through abdominal greater omental hiatus, is a rare disease that lacks specific physical features, which makes its preoperative diagnosis difficult. This study aims the clinical characteristics and radiological findings of 15 cases of TOH.
Methods: From 2009 to 2021, we encountered 15 cases of TOH in which multi-detector row computed tomography (MD-CT) with multiplanar reconstruction (MPR) was helpful for the preoperative diagnosis. We performed a clinical study of patients with TOH.
Results: The average age of the 15 patients (male, n=9; female, n=6) was 73 years (range, 58-91 years). The preoperative diagnosis, based on MD-CT, was TOH in 11 patients and internal hernia in 4 patients. The preoperative diagnosis of TOH was confirmed in 11 of 15 patients (73%). MD-CT showed dilatation of the small intestine on the ventral side of the ascending colon and the descending colon through the omental hiatus, closed loop, and the convergence of the mesentery or small intestine.
Conclusion: The possibility of TOH should be considered when treating patients with obstruction who have no history of laparotomy. MD-CT with MPR is useful for the preoperative diagnosis of TOH.
References
Meyers MA, Charnsangavej C, Oliphant M. Internal abdominal hernias. In: Meyers MA, Charnsangavej C, Oliphant M, eds. Meyers’ dynamic radiology of the abdomen. 6th ed. New York, NY: Springer, 2011;381-409.
Yang DH, Chang WC, Kuo WH, Hsu WH, Teng CY, Fan YG. Spontaneous internal herniation though the greater omentum. Abdomen Imaging. 2009;34(6):731-3. https://doi.org/10.1007/s00261-008-9458-7
Binns PM. Intestinal obstruction due to spontaneous tansomental hernia with previous radiological evidence of the presence of the hernia. Br J CliPract. 1962;16:213-4.PMID: 13869304
Yamaguchi T. A case of incarceration of sigmoid colon into hiatus or grater omentum. Rinsho Geka. 1987;33:1041-5.
Inukai K, Takashima N, Miyai H, Yamamoto M, Kobayashi K, Tanaka M, Hayakawa T. Two patients with spontaneous transomental hernia treated with laparoscopic surgery: a review. JSCR. 2018;4:1-4. https://doi.org/10.1093%2Fjscr%2Frjy070
Malakhia A, Badet N, Delabrousse E. Gastrointestinal: Strangulated transomental hernia. J Gastroenterol Hepatol. 2017;32(7):1282. https://doi.org/10.1111/jgh.13651
Ghahremani GG. Internal abdominal hernias. Surg Clin North Am. 1984;64:393-406. https://doi.org/10.1016/s0039-6109(16)43293-7
Stewart JO. Transepiploic hernia. Br J Surg. 1962;49:649-52. https://doi.org/10.1002/bjs.18004921818
Kimura Y, Iwakawa K, Nishie M, Inagaki M, Iwagaki H. A case of strangulated ileus caused by transomental hernia with reference to previous reported cases (in Japanese with English abstract). Okayama Igakkai Zasshi (J Okayama Med Assoc). 2012;124:149-53.
Udaka T, Marsumoto H, Yamamoto S, Kubo M. Clinical study of strangulated obstruction caused by transomental hernia (in Japanese with English abstract). Journal of Abdominal Emergency Medicine. 2017;37:543-8.
Takeyama N, Gokan T, Ohgiya Y, Satoh S, Hashizume T, Hataya K, Kushiro H, Nakanishi M, Kusano M, Munechika H. CT of internal hernias. Radiographics. 2005;25(4):997-1015. https://doi.org/10.1148/rg.254045035
Camera L, Gennaro AD, Longobardi M, Maspne S, Calabrese E, Vecchio WD, Persico G, Salvatore M, A spontaneous strangulated transomental hernia: Prospective and retrospective multi-detector computed tomography findings. World J Radiol. 2014;6(2):26-30 https://doi.org/10.4329%2Fwjr.v6.i2.26
Sato Y, Tanaka E, Kanou T, Ono Y, Okumoto T, Yoshida Y, Uchiyama H, Watari J. The usefulness of sagittal reconstruction for detecting hernia orifice in transmesenteric hernia (in Japanese with English abstract). Rinshohousyasen. 2016;10:1265-70.
Doishita S, Takeshira T, Uchima Y, Kawaski M, Shmono T, Yamashita A, Sugimoto M, Ninoi T, Shima H, Miki Y. Internal hernias in the era of multidetector CT: correlation of imaging and surgical findings. Radiographics. 2016;36:88-106. https://doi.org/10.1148/rg.2016150113
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Tetsunobu Udaka, Takeyoshi Nishiyama, Tomoaki Ohtsuka, Nobuyuki Watanabe, Izuru Endou, Osamu Yoshida, Hiroaki Asano, Masatoshi Kubo, Hironori Kurokawa
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication, with the work after publication simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
Cited by
