Preoperative Diagnosis of Cecal Herniation Through the Foramen of Winslow

TL;DR

This paper describes a rare case of cecal herniation through the foramen of Winslow, highlighting the role of CT in diagnosis and the need for timely surgery.

Contribution

Adds a new clinical case to the limited literature on cecal herniation through the foramen of Winslow.

Findings

Contrast-enhanced CT identified cecal herniation through the foramen of Winslow into the lesser sac.

Surgical intervention successfully reduced the hernia and prevented bowel ischemia.

The case emphasizes the importance of early diagnosis to avoid complications.

Abstract

Foramen of Winslow hernia is an uncommon internal hernia that may present with nonspecific symptoms and be difficult to diagnose preoperatively. We present the case of a 47-year-old woman who developed sudden epigastric pain and vomiting, in whom contrast-enhanced CT demonstrated herniation of the cecum, ileocecal valve, and part of the transverse colon through the foramen of Winslow into the lesser sac, compressing the gastric antrum. Midline laparotomy revealed a mobile cecum herniated through an enlarged foramen, requiring reduction via opening of the lesser omentum; the bowel was viable, and incidental cholecystectomy and appendectomy were performed due to biliary sludge and malrotation. The patient recovered uneventfully. This case underscores the diagnostic value of CT in identifying characteristic displacement behind the hepatoduodenal ligament and reinforces the importance of prompt surgical intervention to prevent ischemia. Adding another example of this rare presentation contributes to the limited literature on cecal herniation through the foramen of Winslow.

Figures