Silent Danger: Uncovering Greater Omental Internal Herniation

Main Article Content

Wahaj Ayub
Syed Asad Maroof
Shahzeb Khan
Sibghat Ullah
Abdul Mueed Bangash
Muhammad Ayub Khan
Abdul Wahab
Tayyeb Ahmed

Abstract

Background: Internal hernias, though infrequent, are significant causes of intestinal obstruction, contributing to 0.2 to 4% of cases. Greater omental hernias, even rarer at 8%, predominantly affect older individuals, where senile atrophy often leads to omental defects.


Objective: This study aims to highlight the importance of considering internal hernias in the differential diagnosis for intestinal obstruction, particularly in patients without prior abdominal interventions or trauma.


Methods: We review a case of a 75-year-old female presenting with symptoms indicative of internal herniation, including the absence of significant historical abdominal insults. Diagnostic strategies involved physical examinations, imaging via X-ray and CT scans, and eventual surgical intervention.


Results: The patient's initial presentation involved subacute obstruction symptoms, progressing to complete obstruction on the second day of admission. Imaging failed to reveal a definitive transition point, but suggested small bowel obstruction. Surgical findings confirmed an intact herniated bowel loop, successfully treated without complications.


Conclusion: Internal hernias should be suspected in patients with intestinal obstruction symptoms, even in the absence of typical predisposing factors. Prompt recognition and treatment are crucial to prevent severe outcomes such as strangulation and necrosis.

Article Details

How to Cite
Ayub, W., Maroof, S. A., Khan, S., Ullah, S., Bangash, A. M., Khan, M. A., Wahab, A., & Ahmed, T. (2024). Silent Danger: Uncovering Greater Omental Internal Herniation. Journal of Health and Rehabilitation Research, 4(2), 1274–1276. https://doi.org/10.61919/jhrr.v4i2.1085
Section
Articles
Author Biographies

Wahaj Ayub, Khyber Teaching Hospital MTI Peshawar Pakistan.

Chief Surgical Resident, Department of General Surgery, Khyber Teaching Hospital MTI Peshawar, Pakistan.

Syed Asad Maroof, Khyber Teaching Hospital MTI Peshawar Pakistan.

Assistant Professor, Department of General Surgery, Khyber Teaching Hospital MTI Peshawar, Pakistan.

Shahzeb Khan, Khyber Teaching Hospital MTI Peshawar Pakistan.

Consultant Registrar, Department of General Surgery, Khyber Teaching Hospital MTI Peshawar, Pakistan.

Sibghat Ullah, Khyber Teaching Hospital MTI Peshawar Pakistan.

Post Graduate Surgical Resident, Department of General Surgery, Khyber Teaching Hospital MTI Peshawar, Pakistan.

Abdul Mueed Bangash, Khyber Teaching Hospital MTI Peshawar Pakistan.

House Officer, Department of General Surgery, Khyber Teaching Hospital MTI Peshawar, Pakistan.

Muhammad Ayub Khan, Khyber Teaching Hospital MTI Peshawar Pakistan.

Training Medical Officer, Department of General Surgery, Khyber Teaching Hospital MTI Peshawar, Pakistan.

Abdul Wahab, Khyber Teaching Hospital MTI Peshawar Pakistan.

Training Medical Officer, Department of General Surgery, Khyber Teaching Hospital MTI Peshawar, Pakistan.

Tayyeb Ahmed, Khyber Teaching Hospital MTI Peshawar Pakistan.

Post Graduate Surgical Resident, Department of General Surgery, Khyber Teaching Hospital MTI Peshawar, Pakistan.

References

Mathew JD, Cp GB, M B, M R. Small bowel obstruction- a surprise. J Clin Diagn Res. 2015 Jan;9(1):PD20-1. doi: 10.7860/JCDR/2015/8263.5457. Epub 2015 Jan 1. PMID: 25738033; PMCID: PMC4347124.

Lee SH, Lee SH. Spontaneous Transomental Hernia. Ann Coloproctol. 2016 Feb;32(1):38-41. doi: 10.3393/ac.2016.32.1.38. Epub 2016 Feb 29. PMID: 26962535; PMCID: PMC4783511.

Stephenson R, McQueen S, Vedelago J, McGrillen K. Transfalciform greater omental herniation. BMJ Case Rep. 2017 May 9;2017:bcr2017219563. doi: 10.1136/bcr-2017-219563. PMID: 28487304; PMCID: PMC5612518.

Yang DH, Chang WC, Kuo WH, Hsu WH, Teng CY, Fan YG. Spontaneous internal herniation through the greater omentum. Abdom Imaging. 2009 Nov;34(6):731-3. doi: 10.1007/s00261-008-9458-7. PMID: 18791681.

Stephenson R, McQueen S, Vedelago J, McGrillen K. Transfalciform greater omental herniation. BMJ Case Rep. 2017 May 9;2017:bcr2017219563. doi: 10.1136/bcr-2017-219563. PMID: 28487304; PMCID: PMC5612518.

Most read articles by the same author(s)