Internal hernias occur in the peritoneal recesses or folds when a hollow organ, most commonly the small intestine, protrudes through a normal or abnormal aperture in the peritoneum or mesentery. Such hernias do not have specific clinical features and, as a rule, are diagnosed when acute intestinal obstruction occurs. The most common types of internal hernias are paraduodenal (53%), pericecal (13%), foramen of Winslow (8%), transmesenteric (8%), and intersigmoid (6%). Transomental hernias are the rarest (1-4%). We describe an internal small intestinal strangulation in the abnormal aperture of the greater omentum without any findings during an instrumental examination.

Although internal abdominal hernias cause acute intestinal obstruction in no more than 6% of cases, the lethality associated with them reaches 50% in case of untimely diagnosed strangulation and gangrene of the intestine. The rarest type of such hernias is a transomental hernia, which occurs in 1-4% of cases. The diagnosis is difficult when such hernias are strangulated; therefore, they require an emergency operation at the slightest suspicion.

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