A Spontaneous Transomental Hernia: A Rare Cause of Bowel Obstruction

Internal hernias (IH) are rare situations that account for 0.5-3% of all cases of intestinal obstruction. Transomental hernia is a rare subtype, hardly diagnosed, and represents approximately only 2% of internal hernias. In 2018, a 41-year-old female patient presented to Marmara University Hospital emergency service with abdominal pain, nausea, and vomiting. Her medical history included asthma, and she had no abdominal surgery. With the preliminary diagnosis of small bowel obstruction, laparotomy was done and showed a loop of ileum was herniated through into an unusual defect of the omentum. The obstructed loop of the small intestine into the hernia site was reduced. It was seen as viable, so no resection was necessitated. We divided the greater omentum into two parts from the edge of the defect area to prevent recurrences. The patient's postoperative period was uneventful, and she was discharged on the second postoperative day. Small bowel strangulation is more seen in transomental hernia than in other internal hernia types. So it is related to high morbidity and mortality. Surgery should not be delayed to reduce complications.