Foramen of Winslow hernia (FWH) are considered rare even among other internal hernias. It was first described in 1834 and historically had a mortality rate of close to 50%. With modern advancement and availability of cross-sectional imaging, this number has improved dramatically to 5%. Operative management is required for all patients which can be performed with either an open or laparoscopic approach. Preventative measures for recurrence remain controversial as no case of recurrence has been reported to date. We present a case study of a 62 years old woman who presented to the emergency department with severe epigastric pain and a CT scan confirming an FWH. She underwent urgent laparotomy and the hernia was easily reducible without need of intestinal resection. We opted to fixate the right colon and close the foramen of Winslow to prevent future recurrence. She recovered from her surgery well and was discharged home without any complications.
Small bowel malignancies are rare despite it representing 75% of the gastro intestinal (GI) length and 90% of the mucosal surface area. Even then small bowel adenocarcinoma (SBA) accounts for only 30-40% of all small intestine malignancies. Etiology is multifactorial and risk factors include hereditary mutations, inflammatory bowel diseases, coeliac disease. Presenting symptoms are vague and nonspecific and cannot usually be diagnosed by conventional upper and lower GI endoscopy as it is in an inaccessible location. This leads to delayed diagnosis and hence poor prognosis. Mainstay of treatment is surgical resection with adjuvant chemotherapy in advanced disease. We present a case study of a 74 years old woman who presented to the emergency department with small bowel obstruction and radiological features suggestive of underlying small bowel malignancy. She underwent urgent laparotomy with segmental small bowel resection and had intraoperative evidence of wide spread metastasis which was confirmed on subsequent tumor staging scans. She received adjuvant chemotherapy with complete metabolic response at one year post resection. SBA is generally diagnosed at advanced stage due to its anatomical location. Complete surgical resections should always be targeted. However, adjuvant chemotherapy plays a role in advanced disease even though clinical data of evidence is scarce.
No abstract
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.