Double Omental Hernia: A Case Report and Literature Review

Double omental hernia is an exceptionally rare type of internal herniation, in which small bowel loops pass through two distinct defects in the omentum, usually involving both the gastrocolic and gastrohepatic ligaments. Its clinical presentation is often nonspecific, frequently mimicking other causes of acute abdomen and delaying diagnosis. We report a case of a 71-year-old man with a previous near-total colectomy for familial adenomatous polyposis, admitted with acute abdominal pain and radiologic signs suggestive of pneumoperitoneum. Emergency laparotomy revealed a double omental internal hernia, with small bowel herniation through the gastrocolic and hepatogastric ligaments, resulting in obstruction and bowel perforation. Surgical treatment consisted of hernia reduction, segmental enterectomy, and closure of the omental defects. The patient had an uneventful recovery. This case highlights the importance of recognizing a double omental hernia as a potential cause of acute abdomen, especially in patients with previous abdominal surgery.