Congenital Defect in Lesser Omentum Leading to Internal Hernia in Adult: A Rare Case Report

Intestinal obstruction is one of the common clinical condition which is encountered in emergency room. Internal hernia is one of the rare causes of small bowel obstruction accounting for less than 1% of cases. A congenital omental defect is very rare, but can potentially cause internal hernia leading to obstruction or strangulation of the bowel. We present a case of a 54-year-old man who was brought to the emergency department with sudden onset of lower abdominal pain. He had no history of abdominal surgeries or history of trauma. An emergency laparotomy was performed. On exploring the abdominal cavity, the lesser omental defect was detected, 3cm in size. Loops of jejunum had gone through the defect. Congested bowel loop was pulled back and defect was approximated. An adult congenital omental defect is rare; however, it should be considered as one of the differential diagnoses in a relatively young patient with bowel obstruction without external hernia, previous abdominal surgery or trauma.