Herniation through the foramen of Winslow: a laparoscopic approach

Abstract

We describe a case of a young woman with acute epigastric pain. Extensive diagnostic workup suggested a hernia through the foramen of Winslow. A laparoscopic exploration of the abdomen revealed an internal herniation of the cecum and ascending colon behind the hepatoduodenal ligament into the lesser sac. Successful management requires prompt diagnosis and surgical treatment. In our case the internal herniation was uncomplicated and could be reduced laparoscopically. To our knowledge, this is the first documented case of a laparoscopically treated Winslow hernia.

Internal hernia of caecum through the foramen of Winslow

“…One case was excluded, due to the lack of detailed patient history and presentation. The cases were published between 1967 and 2016 describing 24 patients with internal hernias through the foramen of Winslow, 1–3 5–21…”

Foramen of Winslow Hernia: A Case Report and Literature Review

“…Should reduction not be successful, an option is to enter the lesser sac by making an incision in the gastrocolic ligament to assist in delivering the incarcerated segment of bowel (2,12). Successful laparoscopic management of Foramen of Winslow hernia has been reported (1,12). Bowel resection is dependent on the viability of the bowel after its reduction.…”

“…Herniation through the foramen of Winslow is rare, accounting for only 8% of internal hernias and 0.08% of all abdominal hernias (1). It most frequently involves the small bowel (63%), followed by the caecum and right colon (30%) and the transverse colon (7%).…”

Foramen of Winslow hernia: a minimally invasive approach

“…In instances where manual reduction of herniated contents was not possible due to bowel dilation, needle decompression of the involved bowel is described [6,12]. There are a few case reports in which a minimally invasive approach was utilized [13][14][15][16][17][18], none of which required bowel decompression (Table 1). Additionally, none of the existing case reports managed laparoscopically required bowel resection, as non-ischemic, viable bowel was able to be reduced in all instances.…”