Background: Internal hernias in children are uncommon with an incidence of <1%. However, internal hernias should be considered as a cause for an acute abdomen following blunt trauma due to the high risk of strangulation and ischemia of affected bowel loops. Case Presentation: A young girl in middle childhood presented with abdominal pain, nausea, and vomiting. She was a restrained backseat passenger in a motor vehicle accident travelling at 40km/hr. The patient had no previous medical history and was pre-pubertal. Vital signs and blood analysis were normal. A small skin abrasion was present in the right lower quadrant with tenderness on palpation. Ultrasound of the abdomen demonstrated 8mL of pelvic fluid but no solid organ injury. The patient was admitted for observation overnight and then discharged. Three weeks later, the patient re-presented with multiple episodes of vomiting and a one-day history of worsening abdominal pain. Examination was concerning for an acute abdomen. Computed tomography demonstrated a closed loop small bowel obstruction. Urgent laparoscopy revealed severely ischemic, but viable small bowel loops which had herniated through a defect in the greater omentum. The small bowel was released on division of the omental adhesions. The patient recovered well post-operatively. Conclusion: This is a rare case of a transomental hernia which was reduced laparoscopically. The patient’s history of trauma in conjunction with her examination, imaging, and intra-operative findings suggest that the omental defect occurred as a result of the deceleration force from a seatbelt injury. However, a congenital defect remains a possibility.