Intrathoracic Omental Hernia Repaired by Laparoscopy: A Case Report.

Intrathoracic omental hernia (ITOH) is a rare disease with only 17 previously reported cases. ITOH is a hiatal hernia in which the hernia content is only greater omentum, but the cause of the onset is unknown. There have been reports of ITOH requiring emergency surgery due to intussusception during follow-up, and surgery is recommended even if the patient is asymptomatic. The patient is a 79-year-old man. He visited his local doctor with a chief complaint of chest tightness during swallowing. Chest X-ray revealed a mediastinal tumor, and he was referred to our hospital. He was diagnosed with ITOH by MRI and contrast-enhanced CT scan. He was symptomatic and underwent laparoscopic hernia repair. Intraoperative findings revealed a greater omental prolapse into the posterior mediastinum from the right side of the esophageal hiatus. The greater omentum was returned manually into the abdominal cavity, and the hernial orifice was sutured closed with a 3-0 barbed suture. The patient had a good postoperative course and was discharged home on the sixth postoperative day. Laparoscopic surgery for ITOH was considered to be an effective treatment method because of its low invasiveness and easy repair of the hernial orifice.