Small Bowel Obstruction Due to Strangulated Transomental Internal Hernia: A Case Report

Small bowel obstruction secondary to internal hernias is rare, accounting for less than 1% of all cases. We report the case of a 74-year-old male patient with a history of diabetes, occasional alcohol consumption, and chronic smoking. He presented with symptoms of sub-occlusive syndrome including cessation of stool passage without cessation of flatus, diffuse abdominal distension, and bilious vomiting. Abdominal computed tomography (CT) revealed small bowel dilation with air-fluid levels and a transition point in the right flank. Exploratory laparotomy identified a 2.5 cm defect in the greater omentum containing a viable incarcerated small bowel loop. Surgical reduction of the herniated loop and resection of the omental defect were performed. Postoperative recovery was uneventful.