Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2020.236
Autopsy and Case Reports
Clinical Case Report and Review

Cecal bascule herniation through the foramen of Winslow

Aaron M. Williams; Zachary Pickell; Mary R. Shen; Naveen Sangji

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Abstract

ABSTRACT: Bowel obstructions can have a variety of causes, including impacted feces, adhesions, volvulus, non-internal hernias, and in rare cases internal hernias. We report a 63-year-old woman who presented to the emergency department with severe abdominal pain, nausea, vomiting, and obstructive symptoms that had started 12 hours earlier. A computed tomographic scan of the abdomen and pelvis showed a right internal hernia with a cecal bascule traversing through the foramen of Winslow, concerning for a closed-loop obstruction. The patient underwent an exploratory laparotomy with cecal bascule reduction and cecopexy. Given the increased mortality risk if undiagnosed, it is important to remain aware of internal hernias. Patient outcomes are markedly improved with early diagnosis and surgical intervention.

Keywords

Laparotomy, Colorectal Surgery, Intestinal Obstruction, Hernia

References

1 Bobroff LM, Messinger NH, Subbarao K, Beneventano TC. The cecal bascule. Am J Roentgenol Radium Ther Nucl Med. 1972;115(2):249-52. http://dx.doi.org/10.2214/ajr.115.2.249. PMid:5037783.

2 Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 2006;186(3):703-17. http://dx.doi.org/10.2214/AJR.05.0644. PMid:16498098.

3 Ghahremani GG. Internal abdominal hernias. Surg Clin North Am. 1984;64(2):393-406. http://dx.doi.org/10.1016/S0039-6109(16)43293-7. PMid:6729672.

4 Costa G, Ng B, Kociumbas I, Wong S. Herniation of caecum through the foramen of Winslow. Australas Radiol. 2007;51(Spec No):B152-4. http://dx.doi.org/10.1111/j.1440-1673.2007.01772.x. PMid:17875141.

5 Moris D, Tsilimigras DI, Yerokun B, et al. Foramen of Winslow Hernia: a review of the literature highlighting the role of laparoscopy. J Gastrointest Surg. 2019;23(10):2093-9. http://dx.doi.org/10.1007/s11605-019-04353-3. PMid:31420858.

6 Cho YM, Behrenbruch C, Tartaglia C, An V. Caecal herniation and volvulus through the foramen of Winslow: a rare presentation. ANZ J Surg. 2020;90(5):930-2. http://dx.doi.org/10.1111/ans.15434. PMid:31533193.

7 Makarawo T, Macedo FI, Jacobs MJ. Cecal bascule herniation into the lesser sac. World J Clin Cases. 2014;2(12):903-6. http://dx.doi.org/10.12998/wjcc.v2.i12.903. PMid:25516868.

8 Sammut M, Barben C. Herniation of the caecum and ascending colon through the foramen of Winslow: a case report and review. Ann R Coll Surg Engl. 2020;102(2):e39-41. http://dx.doi.org/10.1308/rcsann.2019.0123. PMid:31532226.

9 Valenziano CP, Howard WB, Criado FJ. Hernia through the foramen of Winslow: a complication of cholecystectomy: a case report. Am Surg. 1987;53(5):254-7. PMid:3579035.

10 Puig CA, Lillegard JB, Fisher JE, Schiller HJ. Hernia of cecum and ascending colon through the foramen of Winslow. Int J Surg Case Rep. 2013;4(10):879-81. http://dx.doi.org/10.1016/j.ijscr.2013.07.014. PMid:23973900.

11 Henisz A, Matesanz J, Westcott JL. Cecal Herniation through the Foramen of Winslow. Radiology. 1974;112(3):575-8. http://dx.doi.org/10.1148/112.3.575. PMid:4843288.

12 Ohkuma R, Miyazaki K. Hernia through the foramen of Winslow. Jpn J Surg. 1977;7(3):151-7. http://dx.doi.org/10.1007/BF02469346. PMid:926470.

13 Cohen DJ, Schoolnik ML. Herniation through the foramen of Winslow. Dis Colon Rectum. 1982;25(8):820-2. http://dx.doi.org/10.1007/BF02553325. PMid:7172954.

14 Lemish W, Cameron D. Caecal herniation through the foramen of Winslow. Australas Radiol. 1989;33(1):109-10. http://dx.doi.org/10.1111/j.1440-1673.1989.tb03248.x. PMid:2712783.

15 Wojtasek DA, Codner MA, Nowak EJ. CT diagnosis of cecal herniation through the foramen of Winslow. Gastrointest Radiol. 1991;16(1):77-9. http://dx.doi.org/10.1007/BF01887310. PMid:1991616.

16 Samson T, Tercero F, Sato K, Awad ZT, Filipi CJ. Cecal herniation through the foramen of Winslow after laparoscopic Nissenfundoplication. Surg Endosc. 2001;15(12):1490. http://dx.doi.org/10.1007/s004640041027. PMid:11965478.

17 Webb LH, Riordan WP. Internal herniation of the cecum through the foramen of Winslow. Am Surg. 2009;75(12):1252-3. http://dx.doi.org/10.1177/000313480907501220. PMid:19999922.

18 Azar AR, Abraham C, Coulier B, Broze B. Ileocecal herniation through the foramen of Winslow: MDCT diagnosis. Abdom Imaging. 2010;35(5):574-7. http://dx.doi.org/10.1007/s00261-009-9582-z. PMid:19866231.

19 Rajeswaran G, Selvakumar S, King C. Internal herniation of the caecum into the lesser sac: an unusual cause of an acute abdomen (2009: 10b). Eur Radiol. 2010;20(1):249-52. http://dx.doi.org/10.1007/s00330-009-1450-2. PMid:20063081.

20 Daher R, Montana L, Abdullah J, D’Alessandro A, Chouillard E. Laparoscopic management of foramen of Winslow incarcerated hernia. Surg Case Rep. 2016;2(1):9. http://dx.doi.org/10.1186/s40792-016-0139-4. PMid:26943685.

21 Tse G, Sollei T, Ali SM, Kukreja N. Caecal herniation through the foramen of Winslow. BJR Case Rep. 2016;2(2):20150330. http://dx.doi.org/10.1259/bjrcr.20150330. PMid:30363613.

22 Ayoob F, Michael R, Chadnick Z, Fasanya C. Internal hernia of caecum through the foramen of Winslow. BMJ Case Rep. 2019;12(7):e228239. http://dx.doi.org/10.1136/bcr-2018-228239. PMid:31266756.

23 Azer M, Lira-Schuldes AD, Volkers HU. Internal herniation of the caecum and the ascending colon through the foramen of Winslow. J Surg Case Rep. 2020;2020(3):rjaa029. http://dx.doi.org/10.1093/jscr/rjaa029. PMid:32153762.

24 Madiba TE, Thomson SR, Church JM. The management of cecal volvulus. Dis Colon Rectum. 2002;45(2):264-7. http://dx.doi.org/10.1007/s10350-004-6158-4. PMid:11852342.

25 Osvaldt AB, Mossmann DF, Bersch VP, Rohde L. Intestinal obstruction caused by a foramen of Winslow hernia. Am J Surg. 2008;196(2):242-4. http://dx.doi.org/10.1016/j.amjsurg.2007.05.058. PMid:18436183.

26 Dorian AL, Stein GN. Hernia through foramen of Winslow: report of a case with preoperative roentgen diagnosis and successful surgical management. Surgery. 1954;35(5):795-801. PMid:13156898.
 


Submitted date:
08/18/2020

Accepted date:
10/01/2020

Publication date:
01/28/2021

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