2020 Volume 40 Issue 6 Pages 751-754
A 63–year–old man presented to another doctor complaining of abdominal pain. Computed tomography (CT) did not reveal the cause of the abdominal pain. However, about 5 hours later, the abdominal symptoms worsened greatly and he was referred to our hospital. Physical examination revealed abdominal distension and muscle guarding, and CT showed dilated loops of the small intestine herniating through the foramen of Winslow into the space between the portal vein and inferior vena cava. Under the diagnosis of herniation through the foramen of Winslow, emergency laparotomy was performed. Intraoperatively, we found a 60–cm segment of the ileum incarcerated through in the lesser omentum via the foramen of Winslow. As this segment of the small intestine had become ischemic and necrotic, we performed intestinal resection, and did not close the foramen. Hernia through the foramen of Winslow is rare and often overlooked, but the characteristic findings on CT enabled a precise preoperative diagnosis in our case. In this case report, we wish to emphasize that a hernia through the foramen of Winslow can worsen rapidly, and demonstrate the course of progression on CT.
