Transomental hernia causing small bowel obstruction: an uncommon surgical emergency and literature review

Transomental hernia (TOH) is an exceedingly rare subtype of internal hernia, often leading to acute small bowel obstruction with a high risk of ischemia. We present the case of a 58-year-old male with a history of laparoscopic inguinal hernia repair who developed abdominal pain, distension, vomiting, and obstipation. Contrast-enhanced computed tomography revealed clustered dilated ileal loops with a transition point suggestive of internal herniation. Exploratory laparotomy confirmed a TOH through the greater omentum without bowel ischemia. The defect was divided, and the postoperative course was uneventful. Due to its nonspecific presentation and diagnostic difficulty, TOH is frequently identified only at surgery. Prompt recognition and timely surgical management are essential to prevent serious complications.