A RARE CASE OF TRANSOMENTAL HERNIA

A rare presentation of small bowel obstruction as TRANSOMENTAL Herniation through a rent in the free hanging omentum. Few cases have been reported worldwide. A diagnosis of exclusion with necessity of high index of suspicion especially in a virgin abdomen with prior vague episodes of pain abdomen and spontaneous resolution of symptoms especially in elderly and frail individuals. Most causes are idiopathic and more recently iatrogenic with increasing incidence due to laparoscopic injury to the omentum unrecognized in the primary procedure. Diagnosis is also by a D-LAP when available. Early diagnosis leads to lesser morbidity avoiding resection if intervened early prior to strangulation. Rarer forms of herniation limited to the lesser sac need thorough search by accessing the lesser sac also.