Transomental hernia resulting in a closed loop small bowel obstruction: delayed presentation following paediatric blunt abdominal trauma

BMJ Case Rep. 2025 Jan 25;18(1):e264336. doi: 10.1136/bcr-2024-264336.

Abstract

While internal hernias are rare in the paediatric population, it should be considered as a cause for an acute abdomen following blunt trauma. Internal hernias represent a surgical emergency that requires prompt recognition due to the high risk of strangulation and ischaemia of affected bowel loops. The case of a transomental hernia (TOH) is described in a young girl. She re-presented to the emergency department with acute abdominal pain 3 weeks following a motor vehicle accident where she was a restrained passenger. A computed tomography scan demonstrated a closed loop small bowel obstruction with features of ischaemia, which was likely secondary to an internal hernia. Urgent surgical intervention revealed a TOH containing ischaemic but viable loops of small bowel. Laparoscopic reduction of the hernia was successful, and the patient made a good recovery.

Keywords: General surgery; Paediatric Surgery.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Injuries* / complications
  • Abdominal Injuries* / surgery
  • Accidents, Traffic
  • Child
  • Female
  • Humans
  • Internal Hernia / complications
  • Internal Hernia / surgery
  • Intestinal Obstruction* / diagnosis
  • Intestinal Obstruction* / diagnostic imaging
  • Intestinal Obstruction* / etiology
  • Intestinal Obstruction* / surgery
  • Intestine, Small* / diagnostic imaging
  • Intestine, Small* / surgery
  • Laparoscopy
  • Tomography, X-Ray Computed*
  • Wounds, Nonpenetrating* / complications