Nadir bir incebarsak tıkanıklık nedeni olarak transomental herni : Olgu sunumu
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Date
2009
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Abstract
İnternal herniler ince bağırsak obstrüksiyonunun nadir görülen bir nedeni olup insidansı %1’den daha az olarak bildirilmiştir. Transomental herni ise, internal hernilerin nadir rastlanan şekillerinden birisidir. Bu hernilerde içeriğin boğulma ve nekroza kadar giden dolaşım bozukluğu riski nedeniyle zamanında tanı konulması önemlidir. Bu olguda ileus belirtileri nedeniyle ameliyat ettiğimiz transomental herni sunuldu. Kolik tarzında ağrı ile acil servise başvuran 27 yaşındaki bayan hasta, yaklaşık on yıldır tekrarlayan karın ağrısı atakları geçiriyordu. Barsak tıkanıklığı ön tanısı ile yapılan ameliyatta ince bağırsağın omentum majustaki defekten fıtıklaştığı gözlendi. Fıtıklaşan ince barsaklar rezeksiyon yapılmadan redükte edildi. Ameliyat sonrası komplikasyon gelişmeden hasta taburcu edildi. Transomental herniler her nekadar nadir görülse de, genç ve daha önce ameliyat geçirmemiş, ve barsak tıkanıklığı görülen hastaların ayırıcı tanısında akılda tutulmalıdır. Bu hastalarda gecikmeden ameliyat kararı verilmesi önemlidir.
Intestinal obstructions that account for less than 1% of all. Of these, transomental hernia is one of the rarest forms with an unknown etiology. Because of the risk of strangulation of hernia contents, immediate diagnosis is essential. We report a case of transomental hernia that was operated for signs of ileus. The patient was a 27-year old woman admitted with a colicky abdominal pain. She told that her pain lasted for ten years with repetitive attacks. During process of laparotomy, small intestine had herniated through windows in the greater omentum with a distended proximal segment. Herniated part was retrieved without resection. Then, she was discharged without any complication. Although relatively uncommon, transomental hernias should be included in the differential diagnosis of small bowel obstruction in young patients with repetitive abdominal painful attacks without any history of previous abdominal surgery.
Intestinal obstructions that account for less than 1% of all. Of these, transomental hernia is one of the rarest forms with an unknown etiology. Because of the risk of strangulation of hernia contents, immediate diagnosis is essential. We report a case of transomental hernia that was operated for signs of ileus. The patient was a 27-year old woman admitted with a colicky abdominal pain. She told that her pain lasted for ten years with repetitive attacks. During process of laparotomy, small intestine had herniated through windows in the greater omentum with a distended proximal segment. Herniated part was retrieved without resection. Then, she was discharged without any complication. Although relatively uncommon, transomental hernias should be included in the differential diagnosis of small bowel obstruction in young patients with repetitive abdominal painful attacks without any history of previous abdominal surgery.
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Volume
7
Issue
3
