Life-Threatening Internal Hernia Through an Omental Band With Closed-Loop Obstruction in a Virgin Abdomen and Normal Laboratory Findings: A Case Report

Small bowel obstruction (SBO) is a surgical emergency commonly caused by adhesions from prior abdominal surgeries or hernias. In contrast, SBO caused by omental bands with no history of trauma or abdominal surgeries is rare, and only a few cases have been reported. We present a case of a previously healthy 44-year-old male who presented with sudden, severe generalized colicky abdominal pain after eating, associated with nausea, vomiting, and abdominal tenderness, without distension. Initial lab results and X-ray findings were unremarkable. Intravenous contrast computed tomography (CT) scan revealed closed-loop jejunal obstruction with irreversible ischemic changes. Emergency intra-operative findings indicated mechanical obstruction caused by an omental band, which led to bowel necrosis. Laparoscopic necrotic bowel resection and anastomosis were performed, and the patient recovered uneventfully. The lack of specific signs and symptoms associated with internal hernias (IHs) poses a tremendous diagnostic challenge, with CT scans playing a pivotal role in guiding management.