Cecal Herniation and Volvulus through the Foramen of Winslow

Abstract

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Cecal volvulus in rural Kenya: delayed presentation contributes to high mortality

“…Intra-operative findings support the prerequisite factor of anatomical predisposition including a mobile cecum [ 2 ], with some authors citing cultural and dietary influences on intestinal motility [ 1 , 16 ]. Case reports have noted unique circumstances associated with cecal volvulus occurring through the foramen of Winslow [ 17 ], precipitated by acute appendicitis [ 18 ], following colonoscopy [ 19 ], immediately after cardiac surgery [ 20 ], or the presence of a Meckel’s diverticulum [ 21 ] or uterine leiomyoma [ 22 ]. Depending on the presence of colon viability and intestinal gangrene, mortality of various series ranges from 10 to 40% [ 13 , 23 , 24 ], which is consistent with our experience.…”

Caecal volvulus within the lesser sac: a rare cause of large bowel obstruction

“…A resulting caecal volvulus through the foramen of Winslow is a very rare event, with only 11 case reports identified on literature review, the first of these published in 1970 by William Moirika 4 . Patients often present with vague symptoms of upper abdominal pain, minimal distension and obstipation, with one case even describing gastric outlet obstruction as a consequence 1,3,5,6 . CT imaging has improved the early diagnosis of this condition and subsequently led to timely surgical care and reduced mortality 7 …”

“…Internal hernias are rare, accounting for 0.1% of all hernias, but cause an estimated 5% of intestinal obstructions 1,2 . Internal herniation through the foramen of Winslow is an uncommon occurrence, with a prevalence of up to 8% – therefore accounting for just 0.008% of all hernias 2,3 . A resulting caecal volvulus through the foramen of Winslow is a very rare event, with only 11 case reports identified on literature review, the first of these published in 1970 by William Moirika 4 .…”

“…4 Patients often present with vague symptoms of upper abdominal pain, minimal distension and obstipation, with one case even describing gastric outlet obstruction as a consequence. 1,3,5,6 CT imaging has improved the early diagnosis of this condition and subsequently led to timely surgical care and reduced mortality. 7 Often, the most challenging aspect of operative management is reduction of the volvulus or internal hernia.…”

Caecal herniation and volvulus through the foramen of Winslow: a rare presentation

“…Caecal herniation through the foramen of Winslow is a rare occurrence, described previously on two separate case reports by Nguyen et al . and Kamyab . There are no prospective studies to guide standardized management of caecal volvulus.…”