Bowel obstruction following omental patching of aortic grafts

Omental pedicle flaps are commonly interposed between aortic reconstructions and the nearby small bowel to prevent erosion, graft infection, and aortoenteric fistula. While the utility of this technique is intuitive rather than proven, it is easily performed and complications from this approach have rarely been reported. We report two patients in whom clinically significant intestinal herniation beneath such an omental pedicle flap occurred, necessitating relief of acute small bowel obstruction. A simple method of preventing this complication is proposed.