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. 2016:24:14-7.
doi: 10.1016/j.ijscr.2016.04.044. Epub 2016 May 4.

Herniation of the colon through the foramen of Winslow-A case report

Lucia E Duinhouwer  1 , Eva Deerenberg  2 , Elena Rociu  3 , R T J Kortekaas  4
Affiliations

Herniation of the colon through the foramen of Winslow-A case report

Lucia E Duinhouwer et al. Int J Surg Case Rep. 2016.

Abstract

Introduction: Herniation of the bowel through the foramen of Winslow is a rare condition presenting with acute abdominal pain. Diagnostic delay often results in high morbidity and mortality.

Case presentation: A patient presented with right sided acute abdominal pain. Computed tomography showed herniation of the ascending colon through the foramen of Winslow which could be reversed laparoscopically without the need for bowel resection. There were no postoperative complications and no recurrences have occurred to date.

Discussion: Bowel herniation through the foramen of Winslow is very rare, comprising only 8% of all internal herniations. Historically, the majority of cases was diagnosed intra-operatively and bowel resection was necessary because of ischemia. With the introduction of computed tomography, the diagnosis can be made earlier, possibly resulting in a lower morbidity and mortality rate.

Conclusion: Herniation through the foramen of Winslow is a rare condition. Patients will present with sudden onset abdominal pain. Early imaging helps to recognize the diagnosis and could prevent bowel ischemia.

Keywords: Abdominal surgery; Bowel ischemia; Herniation; Laparoscopic surgery.

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Figures

Fig. 1
Fig. 1
Coronal image of the computed tomography scan showing a dilated ascending colon with a herniation of the hepatic flexure between live rand stomach. (A) Stomach. (B) Omental bursa with herniated and distended colon loop. (C) Distended ascending colon.
Fig. 2
Fig. 2
Laparoscopic image showing the herniation through the foramen of Winslow and the distended colon loop in the ometal bursa. (A) Stomach. (B) Omental bursa with herniated and distended colon loop. (C) Hepatoduodenal ligament. (D) Foramen of Winslow.
See this image and copyright information in PMC

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