Displacement of the transverse colon is a highly specific computed tomography finding for the preoperative diagnosis of a transomental hernia

• DOI: 10.1007/s11604-019-00851-1
• Publication Date: 2019-06-29T09:02:49Z
• Authors: Ryota Ito; Kazuhiko Mori; Keisuke Minamimura; Toru Hirata; Takashi Kobayashi; Seiji Kawasaki
• Keywords: Transverse colon

A transomental hernia (TOH) is a rare type of internal hernia and is associated with a high strangulation rate and high mortality rate. Displacement of the transverse colon on computed tomography (CT) may be specific to a TOH and may facilitate an early diagnosis. The aim of this study was to verify the effectiveness of a novel approach assessing displacement of the transverse colon for the preoperative diagnosis of a TOH.We retrospectively reviewed the CT and operative data of 113 patients who underwent surgery for small bowel obstruction (SBO) between 2011 and 2018. The proportion of transverse colon loops posterior to dilated intestinal loops (PTPI) was calculated.The patients were divided into a TOH group (n = 7) and other SBO group (n = 106). The median PTPI was significantly higher in the TOH group than in the other SBO group (67% [0-97%] vs. 0% [0-100%], Wilcoxon's test, p = 0.03). A receiver operating characteristic curve showed that when the PTPI was ≥ 57%, its sensitivity and specificity for a TOH were 71% and 94%, respectively.The PTPI is a reliable quantitative measure to distinguish a TOH from other types of SBOs.