Abstract
Hernia through the foramen of winslow is extremely rare, and only 12 cases have been reported in Japan.
A 56-year-old woman was admitted to the hospital because of abdominal pain and vomiting. Though no muscular protection was noted, tenderness in the epigastrium and infraumbilical region was remarkable. Abdominal X-ray films showed several distended intestional loops with air-fluid levels in the upper abdomen. Analgesics were administered and the clinical course was observed, however, peritonitis-like symptoms occurred. Emergency laparotomy was performed under a diagnosis of acute intestinal obstruction.
During surgery, it was found that a loop of distal ileum towards the caecum, measuring approximately 30 cm in length, was herniated through the foramen of winslow and incarcerated in the lesser sac. As the herniated ileal segment was gangrenous, that intestine was resected, and the foramen of winslow was closed. The patient was discharged on the 37th postoperative day.
