Extensive Herniation and Necrosis of the Small and Large Bowel through the Foramen of Winslow

Abstract

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Internal herniation of the cecum through the foramen of Winslow—a case report

“…Diagnosing a foramen of Winslow hernia preoperatively remains challenging with only 10% of cases diagnosed preoperatively [ 9 ]. Specifically, in this case, both the rarity of disease and complex radiographic findings proved to be barriers for early diagnosis.…”

“…Specifically, in this case, both the rarity of disease and complex radiographic findings proved to be barriers for early diagnosis. The foramen of Winslow hernia being detected retrospectively is a common occurrence amongst surgical teams handling these cases [ 9 ]. The decision to close the foramen was to prevent recurrence and future complications; however, some cases report enlarging the foramen of Winslow to prevent future strangulation, while others have decided to close the defect with omentum with similar success [ 7 ].…”

Internal hernia through the foramen of Winslow

“…Abdominal X-ray does have some nonspecific findings suggestive of internal hernia but is usually inadequate for diagnosis. Diagnosis of a foramen of Winslow hernia, however, is only accomplished in 10% of patients preoperatively [ 3 ]. As previously mentioned this diagnosis is rare and often presents with vague obstructive type symptoms.…”

Hernia del hiato de Winslow

“…La cavidad peritoneal consiste en dos principales espacios, el saco mayor o cavidad peritoneal general y la bolsa epiploica (bursa omentalis), saco menor o transcavidad de los epiplones. Estas cavidades están conectadas por el foramen epiploico de Winslow [1][2][3][4][5][6][7][8] . El hiato de Winslow, o foramen epiploico, es una comunicación virtual entre la cavidad peritoneal mayor y la transcavidad de los epiplones; está limitado en su aspecto anterior por el ligamento hepatoduodenal, en el posterior por la vena cava inferior, en el superior por el lóbulo caudado y en el inferior por el duodeno.…”

“…Actualmente, se describen cuatro tipos de hernias del hiato de Winslow, dependiendo del órgano herniado 4 . Es una entidad de difícil diagnóstico preoperatorio y el pronóstico del paciente depende de la rapidez en la instauración del tratamiento quirúrgico, ya que la morbimortalidad se acerca al 50 % cuando existe compromiso vascular del órgano afectado [1][2][3][4][5][6][7][8][9][10] .…”