International journal of surgery case reports · 2026
A rare case of lesser omental hernia in a male patient following total colectomy.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Abe Yoshihito, Hiyoshi Yukiharu, Ouchi Mayuko, Ogawa Katsuhiro, Miyamoto Yuji, Iwatsuki Masaaki
Аннотация
INTRODUCTION AND IMPORTANCE: A lesser omental hernia is a rare internal hernia in which intestinal loops become entrapped through a defect in the lesser omentum, potentially causing bowel obstruction. Its diagnosis is challenging because of nonspecific symptoms that resemble those of other gastrointestinal diseases. This report presents a case of lesser omental hernia following total colectomy.
CASE PRESENTATION: A 65-year-old male with a history of laparoscopic total colectomy for ulcerative colitis 4 years prior presented with acute abdominal pain and distension. Computed tomography (CT) revealed a closed-loop small-bowel obstruction, leading to emergency surgery. Intraoperatively, no adhesions were found, but nearly the entire small intestine had herniated through a small foramen in the lesser omentum, passing dorsally behind the stomach. The intestine was repositioned, and the foramen was sutured closed. The patient was discharged on postoperative day 15, with no recurrence observed at the 6-month follow-up examination.
CLINICAL DISCUSSION: A lesser omental hernia may occur after colectomy due to iatrogenic disruption of the gastrocolic ligament. This case represented a type II hernia, with the small intestine prolapsing from the retrogastric space through a defect in the lesser omentum. A review of eight post-colectomy cases showed that all were type II. Diagnosis is difficult, but CT findings such as anteriorly displaced, dilated bowel loops and gastric distortion are key. Careful CT evaluation and intraoperative identification are essential for appropriate diagnosis and treatment.
CONCLUSION: A lesser omental hernia can occur after total colectomy. CT imaging is valuable for diagnosis, and surgical intervention is often required.
CASE PRESENTATION: A 65-year-old male with a history of laparoscopic total colectomy for ulcerative colitis 4 years prior presented with acute abdominal pain and distension. Computed tomography (CT) revealed a closed-loop small-bowel obstruction, leading to emergency surgery. Intraoperatively, no adhesions were found, but nearly the entire small intestine had herniated through a small foramen in the lesser omentum, passing dorsally behind the stomach. The intestine was repositioned, and the foramen was sutured closed. The patient was discharged on postoperative day 15, with no recurrence observed at the 6-month follow-up examination.
CLINICAL DISCUSSION: A lesser omental hernia may occur after colectomy due to iatrogenic disruption of the gastrocolic ligament. This case represented a type II hernia, with the small intestine prolapsing from the retrogastric space through a defect in the lesser omentum. A review of eight post-colectomy cases showed that all were type II. Diagnosis is difficult, but CT findings such as anteriorly displaced, dilated bowel loops and gastric distortion are key. Careful CT evaluation and intraoperative identification are essential for appropriate diagnosis and treatment.
CONCLUSION: A lesser omental hernia can occur after total colectomy. CT imaging is valuable for diagnosis, and surgical intervention is often required.