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Internal hernia of caecum through the foramen of Winslow

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Internal hernias through the foramen of Winslow are very rare. An 80-year-old female patient presented with epigastric and right upper quadrant pain associated with abdominal distention, nausea and vomiting for… Click to show full abstract

Internal hernias through the foramen of Winslow are very rare. An 80-year-old female patient presented with epigastric and right upper quadrant pain associated with abdominal distention, nausea and vomiting for 1 day. A CT scan showed an internal hernia with terminal ileum and caecum identified within the lesser sac. The diagnosis was confirmed by laparotomy. A right hemicolectomy was performed to prevent further recurrence. We reviewed case reports with the same presentation by searching the Pubmed database using the keywords: ‘foramen Winslow hernia, cecum’. We identified 23 publications. Our review extracted the following information: presentation, anatomical findings, pathological causes and surgical management. Misdiagnosis was common due to the limitations of plain abdominal X-rays. Abdominal CT scan is now the preferred radiological study and is more effective in establishing a diagnosis. Surgical treatment options varied. Right hemicolectomy has emerged as the preferred procedure to decrease the rate of recurrence.

Keywords: hernia; foramen winslow; internal hernia; hernia caecum; caecum foramen

Journal Title: BMJ Case Reports
Year Published: 2019

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