A Case of Transepiploic Hernia which was Successfully Diagnosed and Treated under the Laparoscopic Surgery

Transepiploic hernia is rare and asymptomatic, making it difficult to diagnose preoperatively. We report a case of transepiploic hernia successfully diagnosed and treated laparoscopically. A 16-year-old woman seen for abdominal pain had no history of laparotomy or abdominal injury. Abdominal X-ray and CT showed the presense of a small amount of intestinal gas. She was admitted with a diagnosis of acute abdomen. Four hours later, she suddenly vomited with great abdominal pain. We suspected strangulated ileus due to an internal hernia and conducted emergency surgery by laparoscope. The small intestine had herniated through an abnormal hiatus of the greater omentum. A single loop was strangulated, but not necrotic. Strangulation was released laparoscopically and the greater omentum opened. Three days after surgery, she was discharged. No other cases than this have, to our knowledge, been diagnosed and treated laparoscopically. We therefore suggest that laparoscopy is useful in diagnosis or repositioning when an internal hernia is suspected.