Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Feb:115:109312.
doi: 10.1016/j.ijscr.2024.109312. Epub 2024 Jan 26.

A surgical case report of an epiploic hernia - A mobile right colon herniating through the foramen of Winslow

Shubham Jain  1 , Ashrafun Nessa  2 , Mark Gandhi  3 , Radhakrishnan Ganesh  4
Affiliations
Case Reports

A surgical case report of an epiploic hernia - A mobile right colon herniating through the foramen of Winslow

Shubham Jain et al. Int J Surg Case Rep. 2024 Feb.

Abstract

Introduction: An Epiploic Hernia is an extremely rare type of abdominal hernia with <0.1 % incidence where the bowel or other intra-abdominal contents herniate through the Foramen of Winslow. A case of an Epiploic hernia in a middle-aged female is presented here.

Presentation of case: A woman in her 60s was admitted to a tertiary level hospital with severe right sided intermittent upper abdominal pain associated with nausea, bloating and constipation. The symptoms were thought to be due to biliary colic and managed conservatively. Since the symptoms persisted and a computed tomography scan of abdomen was organized. CT scan showed that the caecum was in the upper left quadrant. A laparoscopy was performed and demonstrated that her right colon was mobile herniating through the Foramen of Winslow into the lesser sac. The hernia was reduced, and the bowel was viable. The patient was discharged with no complications.

Discussion: There have been case reports of small bowel as the content of the hernia with lesser occurrences of caecum, ascending colon, transverse colon, gall bladder, omentum, or Meckel's diverticulum. A caecal herniation through the Foramen of Winslow is reported only with an incidence of 0.02 %. <10 % of these Epiploic hernias are diagnosed preoperatively making it a potentially life-threatening condition if not treated promptly due to high risk of bowel strangulation and mortality of up to 50 %.

Conclusion: A high index of suspicion is needed for the diagnosis of this internal hernia and radiological investigation is fundamental in making this diagnosis for allowing prompt surgical treatment.

Keywords: Blandin's hernia; Epiploic hernia; Foramen of Winslow; Internal hernia; Mobile right colon.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest None.

Figures

Fig. 1
Fig. 1
a. Axial CT representation showing caecum lying in the lesser sac. Fig. 1b. Axial Representation of the Epiploic Hernia. Fig. 1c. Coronal view of CT scan showing the caecum sitting in the lesser sac. Fig. 1d. Coronal oblique view showing the caecum and terminal ileum herniating into the lesser sac through the epiploic foramen.
See this image and copyright information in PMC

References

    1. Takeyama N., Gokan T., Ohgiya Y., Satoh S., Hashizume T., Hataya K., et al. CT of internal hernias. Radiogr Rev Publ Radiol Soc N Am Inc. 2005;25(4):997–1015. - PubMed
    1. Martin L.C., Merkle E.M., Thompson W.M. Review of internal hernias: radiographic and clinical findings. AJR Am. J. Roentgenol. 2006 Mar;186(3):703–717. - PubMed
    1. Sohrabi C., Mathew G., Maria N., Kerwan A., Franchi T., Agha R.A. The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int. J. Surg. Lond. Engl. 2023;109(5):1136. - PMC - PubMed
    1. Thomas J.M., Van Fossen K. StatPearls [Internet] StatPearls Publishing; Treasure Island (FL): 2023. Anatomy, abdomen and pelvis: foramen of Winslow (omental foramen, epiploic foramen)http://www.ncbi.nlm.nih.gov/books/NBK482186/ [cited 2023 Apr 25]. Available from: - PubMed
    1. Erskine J.M. Hernia through the foramen of Winslow. A case report of the cecum incarcerated in the lesser omental cavity. Am. J. Surg. 1967;114(6):941–947. - PubMed

Publication types