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

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Abstract

Purpose

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.

Materials and methods

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.

Results

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.

Conclusion

The PTPI is a reliable quantitative measure to distinguish a TOH from other types of SBOs.

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Abbreviations

CT:

Computed tomography

PTPI:

Proportion of transverse colon loops posterior to dilated intestinal loops

ROC:

Receiver operating characteristic

SBO:

Small bowel obstruction

TOH:

Transomental hernia

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Funding

No funding was received for this work.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Mitsui Memorial Hospital, Kanda-Izumi-cho 1, Chiyoda-ku, Tokyo, 101-8643, Japan

    Ryota Ito, Kazuhiko Mori, Keisuke Minamimura, Toru Hirata, Takashi Kobayashi & Seiji Kawasaki

Authors
  1. Ryota Ito
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  2. Kazuhiko Mori
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  3. Keisuke Minamimura
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  4. Toru Hirata
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  5. Takashi Kobayashi
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  6. Seiji Kawasaki
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Corresponding author

Correspondence to Kazuhiko Mori.

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Conflict of interest

All authors have no conflicts of interest to declare.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Our institutional review board approved this retrospective study.

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Informed consent was obtained from all individual participants included in the study.

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Ito, R., Mori, K., Minamimura, K. et al. Displacement of the transverse colon is a highly specific computed tomography finding for the preoperative diagnosis of a transomental hernia. Jpn J Radiol 37, 605–611 (2019). https://doi.org/10.1007/s11604-019-00851-1

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  • DOI: https://doi.org/10.1007/s11604-019-00851-1

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