Strangulated Lesser Omentum Hiatus Hernia: A Rare Case Report and a Literature Review

Intestinal obstruction caused by primary intraperitoneal hernia is infrequent and difficult to diagnose. Incorrect diagnosis and delayed surgical treatment will lead to serious consequences. We report a rare case of a 62-year-old Chinese woman with strangulated lesser omentum hiatus hernia. Contrast-enhanced abdominal computed tomography (CT) scan is recommended for early revelation of direct and indirect signs. We propose three diagnostic points of primary intraperitoneal hernia: (1) "Three-no" pathography: with no history of abdominal operation, abdominal trauma, or abdominal infection. (2) The disease begins with mechanical intestinal obstruction, then turns easily into strangulated intestinal obstruction. (3) It excludes intestinal wall lesions and intestinal blockage. We also summarize the surgical procedure in four steps. We hope this case can provide a reference for the diagnosis and treatment of similar situations.