Foramen of Winslow herniation is a rare occurrence with a high mortality; it presents a diagnostic challenge with subtle clinical and radiological features. We present a case of caecal herniation through the foramen of Winslow creating a closed loop obstruction which remained undiagnosed until laparotomy. Reduction was achieved with gentle traction after first decompressing the caecum whilst still within the lesser sac.
Post-traumatic abdominal aortic pseudoaneurysms remain a rare yet severe complication of aortic injuries and may present many years later. Clinical presentations vary, from the traditional aneurysmal symptoms of abdominal and/or back pain with or without a pulsatile mass, to a fatal rupture. We present the case of a man aged 42 years, with a history of blunt abdominal trauma 14 years ago, presenting with symptoms of non-specific lower abdominal pain and a recent history of straining due to constipation. Clinical examination revealed umbilical bruising, in keeping with Cullen's sign, and extensive postsacral bruising. This case highlights some of the atypical manifestations of aneurysmal rupture and the importance of early recognition and management.
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