Ann Surg Treat Res.  2017 Feb;92(2):113-116. 10.4174/astr.2017.92.2.113.

Spontaneous reduction of small bowel herniation through the foramen of Winslow: importance of a timely approach

• Cho HG
• Kang J

• KMID: 2367925
• DOI: http://doi.org/10.4174/astr.2017.92.2.113

Abstract

We present the case of young female patient presenting with acute onset abdominal pain. Abdominopelvic CT revealed herniation through the foramen of Winslow. The patient was transferred to our hospital and underwent laparoscopic exploration. Though spontaneous reduction was detected, segmental resection of the impacted small bowel was inevitable due to ischemic change. Our case suggests that reducing the time until surgery is very important to lower the probability of bowel resection in case of small bowel herniation through the foramen of Winslow.

Keyword

Foramen of Winslow; Herniation; Small intestine

MeSH Terms

Abdominal Pain
Female
Humans
Intestine, Small

Figure

• 

  Fig. 1 Abdominopelvic CT. CT frontal slice showing a segment of the small bowel passing through the foramen of Winslow behind the portal vessels (A) and a distended small bowel (B) in the lesser sac, with a displaced stomach (S).

Reference

1. Harnsberger CR, McLemore EC, Broderick RC, Fuchs HF, Yu PT, Berducci M, et al. Foramen of Winslow hernia: a minimally invasive approach. Surg Endosc. 2015; 29:2385–2388.

2. Ferguson RA, Paget C, Ferrara J. Selective nonoperative management of foramen of Winslow hernias. Am Surg. 2015; 81:E141–E142.

3. Patel V, Newton R, Wakely S, Rajaratnam K, Ramesh S. Caecal herniation through the foramen of Winslow: a rare cause of bowel obstruction. Updates Surg. 2013; 65:241–244.

4. Daher R, Montana L, Abdul lah J, d'Alessandro A, Chouillard E. Laparoscopic management of foramen of Winslow incarcerated hernia. Surg Case Rep. 2016; 2:9.

5. Garg S, Flumeri-Perez G, Perveen S, DeNoto G. Laparoscopic repair of foramen of Winslow hernia. Int J Angiol. 2016; 25:64–67.

6. May A, Cazeneuve N, Bourbao-Tournois C. Acute small bowel obstruction due to internal herniation through the Foramen of Winslow: CT diagnosis and laparoscopic treatment. J Visc Surg. 2013; 150:349–351.

7. Powell-Brett SF, Royle JT, Stone T, Clarke RG. Caecum herniation through the Foramen of Winslow. J Surg Case Rep. 2012; 12. 11. 2012(12):DOI: 10.1093/jscr/rjs016.

8. Puig CA, Lillegard JB, Fisher JE, Schiller HJ. Hernia of cecum and ascending colon through the foramen of Winslow. Int J Surg Case Rep. 2013; 4:879–881.

9. Sikiminywa-Kambale P, Anaye A, Roulet D, Pezzetta E. Internal hernia through the foramen of Winslow: a diagnosis to consider in moderate epigastric pain. J Surg Case Rep. 2014; 06. 25. 2014(6):DOI: 10.1093/jscr/rju065.

10. Erskine JM. Hernia through the foramen of Winslow. A case report of the cecum incarcerated in the lesser omental cavity. Am J Surg. 1967; 114:941–947.