術前診断しえた高齢者の大網裂孔ヘルニアの１例

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  • A Case of Transomental Hernia in A 95-Year-old Woman.

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A 95-year-old woman diagnosed with a bowel obstruction was referred to our department for abdominal pain and vomiting. She had no history of laparotomy. Two smooth stenosis of the small intestine was detected by long-tube enterogram, showing 1 small intestinal loop strangulated through an abnormal defect. Computed tomography showed ascites, a strangulated small intestinal-loop, and a mesenterium of the anal side. Laparot-omy was conduced for a diagnosis of internal hernia due to an abnormal defect. Surgery showed the small intestin-e had herniated through the abdominal hiatus of the greater omentum. The strangulated intestinal loop was released and the postoperative course is good. Long-tube enterography and CT were helpful in the preoper-ative diagnosis. In the absence of previous surgery, the differential diagnosis of intestinal obstruction must include internal hernia and early diagnosis is important. This woman is, to our knowledge, the oldest person in Japan to have been operated on for transomental hernia.

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