Laparoscopic management of an ascending colon hernia through the foramen of Winslow

Abstract

Herniation through the foramen of Winslow is rare, with a non-specific clinical presentation and his diagnosis may be difficult. A 44-year-old female was admitted with an acute epigastric abdominal pain. A computed tomography showed an internal hernia of the colon in the lesser sac. Laparoscopic reduction of the herniated contents and the fixation of the ascending colon with several non-absorbable sutures were performed. Twenty months after surgery, the patient has not experienced any recurrence. Computed tomography helps practitioners to the preoperative diagnosis of herniation through the foramen of Winslow, to the viability of the herniated contents and presence of occlusion. In case of herniation through the foramen of Winslow favored by a mobile ascending colon with a misapposition of the right Told fascia, the fixation of the colon with a non-absorbable suture was safe and may prevent the risk of recurrent internal hernia and colonic volvulus.

An ileal conduit retroperitoneal‐pexy: An novel operative technique to treat the rare colonic internal hernia

“…5 Most colonic internal hernias in literature involve the transverse colon, likely due to its redundancy and mobility through a mesenteric pedicle, and occur due to congenital defects. 6,7 This patient had not had his right colon mobilized, and it therefore remained in its normal embryological plane. He had significant adhesions from the ileal conduit to the right colon and lateral abdominal wall.…”

Internal herniation of Meckel's diverticulum through foramen of Winslow

“…Traditionally, most internal hernias have been managed via laparotomy. Several case reports demonstrated the feasibility of the laparoscopic approached to internal hernia reduction and closure of the defect 1,4,8,9 . Laparoscopy can be used to both assess and treat internal hernias.…”

“…Several case reports demonstrated the feasibility of the laparoscopic approached to internal hernia reduction and closure of the defect. 1,4,8,9 Laparoscopy can be used to both assess and treat internal hernias. Bowel resection is indicated if there is questionable viability of the bowel intraoperatively.…”

Simultaneous Winslow and Petersen’s Hernias after a Roux-en-Y Gastric Bypass Causing Bowel Obstruction: Laparoscopic Management and Review of the Literature

“…Despite being rare, FWH has a historic mortality rate of almost 50% due to difficult and delayed diagnosis which often led to advanced bowel ischemia. Most cases had been managed by laparotomy, until recently, when the laparoscopic approach has been clearly favored [13][14][15][16][17][18][19][20][21][22]. Modern technologies such as last generation computed tomography (CT) and indocyanine green (ICG) angiography offer new tools for faster and better workup during IH management [23][24][25].…”