A Case of Lesser Omental Hernia after Laparoscopic Total Colorectomy for Ulcerative Colitis

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  • Ozawa H.
    Department of Surgery, Kitasato University School of Medicine
  • Hatate K.
    Department of Surgery, Kitasato University School of Medicine
  • Sato T.
    Department of Surgery, Kitasato University School of Medicine
  • Onosato W.
    Department of Surgery, Kitasato University School of Medicine
  • Nakamura T.
    Department of Surgery, Kitasato University School of Medicine
  • Kokuba Y.
    Department of Surgery, Kitasato University School of Medicine
  • Ihara A.
    Department of Surgery, Kitasato University School of Medicine
  • Watanabe M.
    Department of Surgery, Kitasato University School of Medicine

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  • 潰瘍性大腸炎に対する大腸全摘術後に小網異常裂孔ヘルニアを呈した１例

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Abstract

We report a case of lesser omental hernia. A 21-year-old woman with a history of laparoscopic total colorectomy for ulcerative colitis presented to our hospital with upper abdominal pain and nausea. On admission, her abdomen was distended and tender. Abdominal radiography and computed tomography revealed dilated loops of small intestine in the upper abdomen. An ileus tube was inserted, but the intestinal dilated shadow did not resolve and a narrow segment of small intestine was found. Surgery was therefore performed on suspicion of adhesive Hens. A laparotomy defect in the lesser omentum was found as the hernial orifice, and 50 cm of jejunum was incarcerated through the bursa. The small intestine was not necrotic, and so was pulled back within the abdomen and the defect of the lesser omentum was sutured. The postoperative course was good, and the patient was discharged after 2 weeks.<BR>The cause of lesser omental hernia is unclear and preoperative diagnosis is difficult. Occurrence of lesser omental hernia is rare, and only 9 cases including this one have been reported in Japan. When caring for ileus patients with a history of colectomy, the possibility of internal hernia should be kept in mind.

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