A rare cause of small intestinal obstruction: Spontaneous strangulated trans-omental hernia

Internal herniation is a very rare condition which can cause small bowel obstruction. Trans-omental hernias are an infrequent form of internal herniation and can be seen without a history of trauma and previous abdominal surgery. An 85-year-old male patient without a history of abdominal surgery or trauma was admitted to the emergency service with severe abdominal pain and vomiting. Physical examination and laboratory tests revealed a diagnosis of ileus. During laparotomy, a trans-omental hernia causing strangulation of the ileum was detected. Resection-anastomosis was performed and the omental defect was disrupted by partial omentectomy. Although trans-omental hernia is a very rare condition, it should be considered in the differential diagnosis of patients without mechanic intestinal obstruction.

Nadir bir ince baðýrsak týkanýklýk nedeni: Spontan strangüle transomental fýtýk

Ýnce baðýrsak týkanýklýðýna neden olabilen internal fýtýklar nadir görülür. Öyküsünde travma ya da cerrahi bir operasyon olmadan da görülebilen transomental fýtýklar daha da nadirdir. Seksen beþ yaþýnda ameliyat ya da travma öyküsü bulunmayan erkek hasta þiddetli karýn aðrýsý ve kusma nedeniyle acil polikliniðimize baþvurdu. Yapýlan fiziksel incelemelerde ileus tanýsý konularak ameliyata alýnan olguda transomental fýtýða baðlý strangülasyona uðramýþ ileum anslarý tespit edildi. Rezeksiyon-anastomoz uygulandý ve omental defekt parsiyel omentektomi ile bozuldu. Transomental fýtýklar çok nadir görülseler de hikayesinde ameliyat ve travma saptanmayan olgularda mekanik baðýrsak týkanýklýðý ayýrýcý tanýsýnda düþünülmelidir.