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Spontaneous Herniation of Transverse Colon

Imaging findings

CT chest and abdomen in a patient with a pre-existing, stable, right-sided diaphragmatic defect shows acute herniation of the transverse colon through the defect, presenting with signs of mechanical bowel obstruction.

Key takeaways

Small, stable-appearing diaphragmatic hernias containing only omental fat can act as a 'ticking time bomb' for visceral herniation. Sudden increases in intra-abdominal pressure can cause acute herniation of the colon or stomach, leading to strangulation or obstruction and requiring prompt surgical repair.

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