Transomental hernias: Multi-detector row computed tomography findings in 15 clinical cases

Abstract

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.

Keywords

• Small bowel obstruction
• Internal hernia
• Transomental hernia
• Multi-detector row computed tomography
• Strangulation