Abstract
Entocele represents only about 1% of all causes for ileus, and Winslow foramen hernia which represents about 8% of all entoceles is extremely rare. This paper presents a recent experience with such a rare case of Winslow foramen hernia with a review of the literature.
A 43-year-old man was seen at the hospital because of abdominal pain. Abdominal plain X-ray film revealed small bowel air forming air-fluid level at a high location of inside portion of the lesser curvature of the stomach. Ileus was suspected and the patient was emergently admitted to the hospital. Abdominal CT visualized a intestine-like shadow with thickened wall incarcerating into the omental bursa from the dilated Winslow foramen. The patient was diagnosed as strangulated hernia due to Winslow foramen hernia. An emergency operation was carried out. Upon operation the ileum by about 30cm incarcerated into the omental bursa from the Winslow foamen and strangulated at 1m distant from the terminal ileum. Reduction of the ileus improved vascular disturbance, and hence excision of the intestine did not demanded.
It has been said that the disease presents difficulty in preoperative diagnosis, but in this case abdominal CT greatly contributed to early diagnosis and early treatment.
