Strangulated Foramen of Winslow Hernia

Losanoff, Julian E.; Kjossev, Kirien T.

doi:10.1159/000172525

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…En effet depuis leur description, moins de 170 cas ont été publiés [9]. Avant l'ère du scanner, le taux de diagnostic préopératoire était de l'ordre de 10 % [2].…”

Section: Discussionunclassified

“…La caecopexie ne permet pas une fixation fiable du caecum et à l'instar des volvulus du caecum, la meilleure technique pour traiter le défaut de fixation du caecum est la résection iléocolique [15]. La fermeture de l'hiatus est techniquement difficilement réalisable [9] et peut être responsable de compression du pédicule hépatique. Dorian et al rapportent un cas de thrombose portale après fermeture de l'hiatus [16].…”

Section: Discussionunclassified

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À propos d'un cas de hernie de l'angle iléocæcal à travers l'hiatus de Winslow

Brunschweiler¹,

Ainseba²,

Daoud³

et al. 2005

Annales de Chirurgie

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“…En effet depuis leur description, moins de 170 cas ont été publiés [9]. Avant l'ère du scanner, le taux de diagnostic préopératoire était de l'ordre de 10 % [2].…”

Section: Discussionunclassified

À propos d'un cas de hernie de l'angle iléocæcal à travers l'hiatus de Winslow

Brunschweiler¹,

Ainseba²,

Daoud³

et al. 2005

Annales de Chirurgie

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“…Sometimes, for an abdominal mass, ultrasonography can be useful [Wachsberg 1994]; for suspicion of a pancreatiffs [Yeoman 1994] CT scan can be of value [Wojtaseck 1991]; a sub occlusive syndrome can be due to an internal hernia and confirmed with a baryum enema [Hamy 1994]. In eight of our cases, the urgency of the clinical pictudon't close it because of the risk of portal vein thrombosis [Gulliano 1993, Losanoff 1997, perhaps the greater omentum should be used.…”

Section: Anatomical Backgroundmentioning

confidence: 99%

Internal hernia. Report of nine cases

Armstrong

Letessier

Génier

et al. 1997

Hernia

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Internal abdominal hernias are rare and develop when one or more viscera protrude through an intraperitoneal orifice while remaining within the peritoneal cavity. This orifice may be normal (Winslow's foramen) or paranormal (peritoneal fossae) ; these hernias possess a sac and are true hernias. Protrusion may be through a pathologic hole, without a sac, realizing an internal prolapse or procidentia. The clinical diagnosis is always difficult and leads to an urgent operation for intestinal obstruction. The treatment is often simple and the results are generally excellent.Internal herniation is a rare condition. In the literature, some case reports have been described, but rarely series. In that of Gullino (1993), fourteen cases are presented and the incidence of these hernias is estimated at between 0,2 and 2% of abdominal hernias, and o.z to 0.9% of autopsies. Often manifesting by intestinal obstruction, diagnosis is usually made at surgery.The aim of our study is to report 9 cases of internal hernia representing different anatomical types. Material and methodsNine patients of a mean age of 71 (range 51-84) were admitted to our department during a period of eighteen years (from 1979 to 1996). Sex 7M/2F. Eight were symptomatic: six presented a clinical picture of small bowel obstruction, two of peritonitis.Only one patient was asymptomatic, the internal hernia was incidentally discovered during surgical exploration for another pathology (gastric cancer).The two cases of peritonitis were: a 66-year-old man with an ileocecal hernia, which required a 45 cm small bowel resection; a 7o-year-old man with a hernia through the foramen of Winslow; a 1 m small bowel resection was necessary but he died during the urgent operation, complicated by fecal peritonitis.The diagnosis was established preoperatively in two cases out of the eight symptomatic patients (or at least there were strong criteria of such a presumed diagnosis).Eight patients (of the nine) were explored urgently (7 midline incisions, 1 transverse). Reduction of the herniated viscera was never a problem but in one case through the foramen of Winslow. Bowel necrosis was found in two cases, which required resection of 1 m and 45 cm of small bowel with immediate restoration of continuity. The closure of peritoneal fossae or an abnormal orifice was done easily with a resorbable suture, while nothing was attempted on the foramen of Winslow. ResultsThere were two deaths: one intra-operatively due to fecal peritonitis, the other was after an inguinal hernia and three successive operations for intestinal obstruction. Both were elderly (over 70) and presented a Winslow's foramen hernia.

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Internal hernias: anatomical basis and clinical relevance

Armstrong

Hamel²,

Grignon³

et al. 2007

Surg Radiol Anat

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The aim of this study was to present and discuss the anatomical basis of internal hernias thanks to our clinical experience of 14 cases. Internal hernias are uncommon cases of acute intestinal obstruction when a viscera protrudes through an intraperitoneal orifice, remaining inside the peritoneal cavity. It excludes iatrogenic post surgical hernias. From an anatomical point of view, three kinds of orifices may be interested. The orifice may be normal: epiploic or omental (Winslow's) foramen, or abnormal through a pathologic transomental hole realizing an internal prolapsus or procidentia, without sac. Or this orifice may be a paranormal peritoneal fossa (para duodenal or retrocaecal) acting as a trap for the bowel: these hernias possess a sac and are considered as true hernias. The clinical diagnosis is always difficult. CT scan can be useful confirming the obstruction and leads to an urgent operation. This retrospective study evaluates diagnosis, management and follow-up according to the type of anatomical orifice and delay of surgery.

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Strangulated Foramen of Winslow Hernia

Cited by 6 publications

References 6 publications

À propos d'un cas de hernie de l'angle iléocæcal à travers l'hiatus de Winslow

À propos d'un cas de hernie de l'angle iléocæcal à travers l'hiatus de Winslow

Internal hernia. Report of nine cases

Internal hernias: anatomical basis and clinical relevance

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