Rathnakar Surag Kajoor, Muniyappa Shridhar, Vishnu Vikram Hubbanageri, Kagali Nagaraj
Junior Resident, Department of General Surgery, ESIC Medical College , Bengaluru, Karnataka, India .
Professor, Department of General Surgery, ESIC Medical College , Bengaluru, Karnataka, India .
J Clin Diagn Res. 2016 Aug;10(8):PD08-9. doi: 10.7860/JCDR/2016/19076.8333. Epub 2016 Aug 1.
Intestinal obstruction is one of the common clinical condition which is encountered in emergency room. Internal hernia is one of the rare causes of small bowel obstruction accounting for less than 1% of cases. A congenital omental defect is very rare, but can potentially cause internal hernia leading to obstruction or strangulation of the bowel. We present a case of a 54-year-old man who was brought to the emergency department with sudden onset of lower abdominal pain. He had no history of abdominal surgeries or history of trauma. An emergency laparotomy was performed. On exploring the abdominal cavity, the lesser omental defect was detected, 3cm in size. Loops of jejunum had gone through the defect. Congested bowel loop was pulled back and defect was approximated. An adult congenital omental defect is rare; however, it should be considered as one of the differential diagnoses in a relatively young patient with bowel obstruction without external hernia, previous abdominal surgery or trauma.
肠梗阻是急诊室常见的临床病症之一。内疝是小肠梗阻的罕见病因之一,占病例不到1%。先天性网膜缺损非常罕见,但可能导致内疝,进而引起肠梗阻或肠绞窄。我们报告一例54岁男性患者,因突发下腹痛被送至急诊科。他无腹部手术史或外伤史。遂进行了急诊剖腹探查术。探查腹腔时,发现一个3厘米大小的小网膜缺损。空肠袢通过了该缺损。将充血的肠袢拉回并缝合缺损。成人先天性网膜缺损罕见;然而,对于相对年轻、无外疝、无既往腹部手术或外伤史的肠梗阻患者,应将其视为鉴别诊断之一。