A CASE OF WINSLOW FORAMEN HERNIA INCARCERATED IN THE ISTHMUS OF BURSA OMENTALIS

Abstract

Winslow foramen hernia is an extremely rare disease of all entoceles. We report our recent experience with a case of Winslow foramen hernia.
A 25-year-old woman was admitted to the hospital because of upper abdominal pain on August 6, 1995, and was kept under close medical observasion. Two days later the abdominal pain was intensified. An emergency operation was carried out with a diagnosis of strangulated ileus 39 hours after the onset of the symptom.
Upon laparotomy the center of the small intestine passed through the Winslow foramen and was incarcerated into the isthmus of bursa omentalis. By incising a part of the isthmus of bursa omentalis, the strangulation was relieved. Enterectomy was not necessary because the circulation of the small intestine was improved after reduction.
In this case, we could not diagnose before the operatrion. Looking back this case retrospectively, we think that we should be able to diagnose before the operation if we entertained the possible presence of Winslow foramen hernia.
Preoperative abdominal CT and ultrasonography that visualized the intestine passing through posterior side of the hepatoduodenal ligament strongly suggested this disease.