A CASE OF STRANGULATED OBSTRUCTION CAUSED BY TRANSOMENTAL HERNIA IN WHICH CT WAS HELPFUL FOR PREOPERATIVE DIAGNOSIS

• WATANABE Jun

  Department of Gastroenterological Surgery, Yokohama City University, School of Medicine

• TAKAHASHI Masazumi

  Department of Surgery, Yokohama Municipal Citizen's Hospital

• MOCHIZUKI Yasuhisa

  Department of Surgery, Yokohama Municipal Citizen's Hospital

• SUGITA Akira

  Department of Surgery, Yokohama Municipal Citizen's Hospital

• SHIMADA Hiroshi

  Department of Gastroenterological Surgery, Yokohama City University, School of Medicine

Bibliographic Information

Other Title

• 術前診断にＣＴが有用であった大網裂孔ヘルニアの１例

Abstract

Transomental hernia often develops into strangulated obstruction, but is difficult to diagnose preoperatively due to lack of specific symptoms. We report a patient with strangulated obstruction due to transomental hernia.<br>A 74-year-old man was admitted to the hospital because of epigastric pain and vomiting. He had no previous history of abdominal surgery or trauma. There was epigastric tenderness and rebound tenderness. His labs showed elevated white blood cell count and CK. On blood gas analysis, his base excess was decreased at -4.6mEq/L. Abdominal CT scan showed ascites collection, many dilated small intestinal loops with intraluminal air and a strangulated small intestinal loop. Moreover, coronary multiplanar reformation (MPR) showed a hernia orifice, the protruded and strangulated small intestinal loop through the orifice, and engorged mesenteric vessels. A diagnosis of strangulated obstruction by internal hernia was made and an emergency operation was performed. We performed resection of the necrosed portion of the small intestine about 50 cm in length that prolapsed and was strangulated through the hiatus of the greater omantum. The patient was discharged from the hospital 11 days after the operation. Multidetector-row CT (MDCT) examination with MPR is very useful for preoperative diagnosis of internal hernia.

Journal

• Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

  Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 68 (11), 2881-2884, 2007

  Japan Surgical Association

Keywords

• 大網裂孔ヘルニア
• 内ヘルニア
• 腸閉塞

Details

• CRID: 1390001204847679104
• NII Article ID: 10020120659
• NII Book ID: AA11189709
• DOI: 10.3919/jjsa.68.2881
• ISSN: 18825133
• ISSN: 13452843
• Web Site: http://www.jstage.jst.go.jp/article/jjsa/68/11/68_11_2881/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2008075591
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed