A CASE OF HERNIA THROUGH FORAMEN OF WINSLOW

Abstract

A 45-year-old man complaining of abdominal distension and upper abdominal pain was referred to the hospital with a diagnosis of intestinal obstruction in the last 10 days of January, 2005. Following abdominal CT scan, the patient was diagnosed as having a hernia through foramen of Winslow. A long tube was placed in expectation of spontaneous reduction of the hernia, but the treatment was unsuccessful. On the next day an emergency operation was performed. Operative findings showed that a 50-cm portion of the small intestine about 200cm distal to the ligament of Treitz was herniated through the foramen of Winslow into the omental bursa, and was strangulated there. Manual reduction of the hernia was easily done by introducing the long tube to the herniated part and sucking the intestinal content into the tube. No intestinal resection was needed, because no intestinal necrosis was seen. The Winslow foramen was slightly enlarged to be two fingerbreadths, but no plication suture was made. Other abnormalities were present.
Hernia through foramen of Winslow is so rare and it accounts for about 8% of all internal hernias. We analyzed a total of 39 domestic cases, including our case, and discussed its clinicopathological characteristics.