腹部鈍的外傷後，遅発性に生じた横行結腸間膜裂孔ヘルニアの1例

A ７７-year-old woman presented to the emergency department with complains of abdominal pain and frequent vomiting.
In the past, she has never been on surgery but she suffered blunt liver injury after motor vehicle accident nine months ago. She was performed trans-catheter arterial embolization to the left hepatic lobe at that time and had been seeing a doctor regularly for post traumatic biloma.
The contrast-enhanced abdominal CT scan revealed a closed loop and a dilatation of a small intestine. She was diagnosed a small bowel obstruction due to a internal hernia.
She was operated urgently. The surgical exploration showed that the congested jejunum incarcerated into an omental bursa, and an adhesion of the jejunum mesentery and a greater omentum.
We found a mesentery hiatus of the transverse colon, through which a higher jejunum had incarcerated into the omental bursa. The jejunum was reduced manually and the hiatus was closed by suture. The patient followed a favorable postoperative course and was discharged on postoperative day６. We report a extremely rare transverse colon hiatal hernia that occurred in the late onset after blunt abdominal injury with the review of the literature.