CT上興味深い像を呈した大網裂孔ヘルニアの1例

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  • A CASE OF TRANSEPIPLOIC HERNIA THAT PRESENTED INTERESTING FINDING OF CT

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A case of transepiploic hernia, that presented interesting findings on CT, is described with a review of the literature. A 66-year-old female was admitted to our hospital because of an epigastric pain and nausea. On admission tederness was in the right lower abdomen. White blood cell count was 6200/ul and CRP was 0.06mg/dl. There was no previous history of undergoing lapalotomy and abdominal injury. Conservative treatment was selected, but two days later ascites increased. CT revealed the dilated small intestine in the right head sided transverse colon. Bloody ascites was confirmed by puncture of the Douglas' pouch. Strangulated ileus was suspected and an emergency operation was carried out. It was found that the jejunum had herniated through an abdominal hiatus of the greater omentum. The one jejunal-loop was strangulated, but not necrotized. The strangulation was released and the greater omentum was opened. We retrospectively think that we might be able to make the preoperative diagnosis based on the location of the intestine on CT.

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