Internal Herniation with Fatal Outcome: Herniation Through an Unusual Apertura between Epiploic Appendices and Greater Omentum

Abstract

Internal hernia is an unusal cause of intestinal obstruction. Herniation related to epiploic appendix is a very rare entity. We herein report a case of internal herniation due to an adhesion between epiploic appendixes and the greater omentum. A 71-year-old woman complaining of abdominal pain and intermittent nausea was operated on with the preoperative diagnosis of intestinal obstruction. Three epiploic appendixes of the left side of the transverse colon and the corresponding part of the greater omentum had created a tunnel and a loop of small bowel 25 cm in length was strangulated. No resection was required after releiving the strangulation. However, the patient died due to massive myocar-dial infarction in the postoperative period. Internal herniation must be included in the differential diagnosis of patients with acute abdomen or intestinal obstruction. A high index of suspicion with prompt surgical intervention may be the key to the reduction of morbidity and mortality.

Key Words:

• Internal hernia
• intestinal obstruction
• bowel strangulation

Additional information

Notes on contributors

H. Kulacoglu

Dr. H. Kulacoglu Bahcelievler, 1.cadde, 109/5 06490, Ankara, Turkey Fax: + 90 312 417 04 06 E-mail: [email protected] [email protected]