Foramen of Winslow hernia: case report of a minimally invasive approach

Abstract

Foramen of Winslow hernias account for 8% of all internal hernias. Their non-specific presentation and often late diagnosis are associated with an estimated mortality of 50%. The use of complementary diagnostic methods facilitates the diagnosis and planning of the therapeutic strategy. Urgent surgery is the appropriate treatment due to the risk of intestinal ischemia, being laparotomy the main form of approach described. Few cases of laparoscopy are referred to in the literature.

Meckel’s Diverticulum in Foramen of Winslow Hernia – A Rare Cause of Bowel Obstruction

“…FOWH accounts for 0.08% of all visceral hernias and 8% of bowel obstruction secondary to internal hernias [1,2]. Historically FOWH was considered difficult to diagnose, often resulting in strangulated bowel contents at the time of presentation [3,4].…”

“…Historically FOWH was considered difficult to diagnose, often resulting in strangulated bowel contents at the time of presentation [3,4]. This was associated with a high mortality rate of up to 50% before the advent of more reliable imaging resources [2]. Luckily this has changed quite significantly with the advent of high-resolution imaging tools.…”

“…Luckily this has changed quite significantly with the advent of high-resolution imaging tools. Easily accessible imaging investigations (i.e., computed tomography) have made accurate diagnosis and early operative management possible, drastically decreasing the mortality rate to 5% [2]. The laparoscopic approach has been more frequently reported in recent papers [2][3][4][5].…”

“…Easily accessible imaging investigations (i.e., computed tomography) have made accurate diagnosis and early operative management possible, drastically decreasing the mortality rate to 5% [2]. The laparoscopic approach has been more frequently reported in recent papers [2][3][4][5]. This is likely to be due to the early assessment and diagnosis, resulting in more stable patients, who are suitable for a minimally invasive operation in contrast to exploratory laparotomy.…”

“…Widespread access to laparoscopic equipment, as well as widely disseminated laparoscopic training also plays an important role [5,6]. There has been some discussion as to whether to perform prophylactic surgical measures to prevent recurrence (foramen closure), with insufficient data to support either [2,7].…”