{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T18:06:14Z","timestamp":1784138774721,"version":"3.55.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Transomental hernia is a rare cause of small bowel obstruction and may be missed before surgery, particularly in a virgin abdomen. We report a 75-year-old woman with no previous abdominal operation who presented with 4\u00a0days of abdominal pain, vomiting, distension, constipation, and reduced urine output. She had leukocytosis and acute kidney injury. Because of renal dysfunction, computed tomography was performed without intravenous contrast. It showed dilated ileal loops, a pelvic transition point, mild ascites, and twisting of mesenteric vessels at the transition point, suggestive of volvulus or closed-loop obstruction. Internal hernia was not diagnosed preoperatively. Emergency laparotomy revealed ileum strangulated through a 3\u00a0cm greater omental defect. Approximately 120\u00a0cm of gangrenous ileum was resected, the defect was excised, and single-layer extramucosal hand-sewn end-to-end anastomosis was performed. The case emphasizes that closed-loop obstruction in a virgin abdomen should prompt early consideration of internal hernia.<\/jats:p>","DOI":"10.1093\/jscr\/rjag586","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:20:50Z","timestamp":1784136050000},"source":"Crossref","is-referenced-by-count":0,"title":["Strangulated transomental hernia causing small bowel obstruction in a virgin abdomen"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2151-0570","authenticated-orcid":false,"given":"Unaiza","family":"Erum","sequence":"first","affiliation":[{"name":"Department of General Surgery, Foundation University , Defence Avenue, DHA Phase-I, Islamabad Capital Territory 44000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer Bin Khalid","family":"Jamil","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Dow University of Health Sciences , Baba-e-Urdu Road, Karachi 74200 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Shahid","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Foundation University , Defence Avenue, DHA Phase-I, Islamabad Capital Territory 44000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Noman","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Dow University of Health Sciences , Baba-e-Urdu Road, Karachi 74200 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrukh","family":"Imtiaz","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Foundation University , Defence Avenue, DHA Phase-I, Islamabad Capital Territory 44000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Zafar","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Foundation University , Defence Avenue, DHA Phase-I, Islamabad Capital Territory 44000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahnoor","family":"Babar","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Foundation University , Defence Avenue, DHA Phase-I, Islamabad Capital Territory 44000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"2026071513204660800_ref1","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s13017-021-00379-8","article-title":"Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper","volume":"16","author":"Amara","year":"2021","journal-title":"World J Emerg Surg"},{"key":"2026071513204660800_ref2","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s13017-019-0240-7","article-title":"Bowel obstruction: a narrative review for all physicians","volume":"14","author":"Catena","year":"2019","journal-title":"World J Emerg Surg"},{"key":"2026071513204660800_ref3","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1111\/ans.16392","article-title":"Non-operative management for small bowel obstruction in a virgin abdomen: a systematic review","volume":"91","author":"Yang","year":"2021","journal-title":"ANZ J Surg"},{"key":"2026071513204660800_ref4","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1007\/s10029-012-1023-1","article-title":"Internal hernias: a brief review","volume":"17","author":"Salar","year":"2013","journal-title":"Hernia"},{"key":"2026071513204660800_ref5","doi-asserted-by":"publisher","first-page":"20","DOI":"10.23750\/abm.v90i5-S.8344","article-title":"Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings","volume":"90","author":"Lanzetta","year":"2019","journal-title":"Acta Biomed"},{"key":"2026071513204660800_ref6","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1148\/radiology.218.1.r01ja5368","article-title":"Internal hernia: clinical and imaging findings in 17 patients with emphasis on CT criteria","volume":"218","author":"Blachar","year":"2001","journal-title":"Radiology"},{"key":"2026071513204660800_ref7","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.ijscr.2019.11.034","article-title":"Transomental hernia: an enigmatic case report causing bowel obstruction in a virgin abdomen","volume":"66","author":"Buainain","year":"2020","journal-title":"Int J Surg Case Rep"},{"key":"2026071513204660800_ref8","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1148\/rg.254045035","article-title":"CT of internal hernias","volume":"25","author":"Takeyama","year":"2005","journal-title":"Radiographics"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/7\/rjag586\/68911427\/rjag586.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/7\/rjag586\/68911427\/rjag586.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:20:51Z","timestamp":1784136051000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag586\/8735052"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":8,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag586","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]},"article-number":"rjag586"}}