Herniation of the colon through the foramen of Winslow—A case report

Abstract

HighlightsHerniation is rare and diagnostic delay increases mortality and morbidity.Patients present with nonspecific acute abdominal pain.Computed tomography helps early diagnosis and could thereby prevent bowel ischemia.Herniation can be reversed laparoscopically without bowel resection in case of early diagnosis.

Laparoscopic surgery in a patient with foramen of Winslow hernia due to large uterine fibroids: a case report and literature review

“…The efficacy of foramen closure in preventing the recurrence of FWH remains debatable. Because of the risk of injury to the bile duct, portal vein, and hepatic artery [ 21 ], some surgeons have obliterated the lesser omentum rather than closing the foramen [ 16 , 18 ]. Nevertheless, no recurrence was observed regardless of the performance of preventive measures.…”

Laparoscopic management of cecum and ascending colon hernia through the foramen of Winslow

“…In 2011, laparoscopy was successfully used in a patient with a foramen of Winslow hernia [10]. Thereafter, several investigators reported the safety and feasibility of the laparoscopic approach, even in cases that required bowel resection [8]. Thus, the best approach is to offer laparoscopic surgery in instances where the diagnosis is preoperatively suspected.…”

“…In previous reports of herniation through the foramen of Winslow, the most common gastrointestinal tube that was involved was the small intestine (63%), followed by the cecum and ascending colon (30%); in only 7% of the cases, herniation involved the transverse colon [8]. Cases of gall bladder herniation [3] or a small bowel diverticulum [5] have been reported [6].…”

“…Unfortunately, physicians are still faced with treating patients with foramen of Winslow hernias. Most case series favor laparotomy [6, 7], and only a few reports have preferred laparoscopy [1, 8]. In cases where the herniated bowel is still viable, treatment involves the reduction of the hernia and prevention of recurrence.…”

Re: Internal herniation through the foramen of Winslow: a rare cause of bowel obstruction

“…Duinhouwer et al did careful search of the literature of last 5 years and found that out of 24 cases, 21 cases have been detected preoperatively and only three cases diagnosed intraoperatively. 2 Although many case report including the index case mentioned that hernia of the foramen of Winslow (HFW) was first described in 1834. 1 This information is inaccurate as the first description of the HFW was provided in 1823.…”