Background/Purpose: A pedicled omental graft can be based on either the left or right gastroepiploic artery, or both. An epigastric hernia must be created in order to bring the omentum to the anterior chest wall. Visceral herniation through this defect is a recognized complication, however, simultaneous gastric and transverse colon herniation has not been reported. Methods: Case report and review of literature. Results: 74 y.o WF who underwent CABG via median sternotomy that was complicated by sternal wound infection. A pedicled omental graft based on both gastroepiploic arteries was used for chest wall reconstruction. Two years later, the patient presented with post prandial nausea, vomiting, and bloating. An upper GI revealed anterior herniation of the stomach with evidence of organoaxial volvulus. Intra-operative findings included simultaneous gastric and transverse colon herniation through a large epigastric and chest wall hernia. Weinzeig (1) reported a 21% incidence of abdominal wall herniation after omental flaps for anterior chest wall reconstruction. Visceral herniation was not noted. Boiskin, 1998 (2) submitted a case report of transverse colon herniation; the first and only of it’s kind. Conclusions: Gastrocolic herniation is a potential complication of omental grafts based on both gastroepiploic arteries.