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Herniation through the foramen of Winslow presenting as obstructive jaundice

B Antao1, J Hamill, M Samuel

  • 1Department of Paediatric Surgery, Institute of Child Health and Great Ormond Street Hospital for Children, London, WC1N 1EH, UK.

Pediatric Surgery International
|May 20, 2005
PubMed

Insights

A rare case of internal hernia through the foramen of Winslow caused obstructive jaundice and midgut volvulus in a 19-month-old child. Intestinal malrotation was the underlying cause, highlighting the need for further investigation post-exomphalos repair.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Congenital Abnormalities

Background:

  • Paraduodenal hernias, specifically through the foramen of Winslow, are exceptionally rare congenital abdominal wall defects.
  • Intestinal malrotation is a common cause of midgut volvulus and can predispose to internal herniation.

Observation:

  • A 19-month-old infant presented with obstructive jaundice and symptoms of midgut volvulus.
  • Imaging revealed herniation of the midgut through the foramen of Winslow, complicated by volvulus.
  • The patient had a history of exomphalos major treated with extraamniotic silo repair in the neonatal period.

Findings:

  • The foramen of Winslow herniation and subsequent midgut volvulus were directly attributed to underlying intestinal malrotation.
  • Surgical intervention was required to address the obstruction and volvulus.

Implications:

  • This case underscores the importance of considering and investigating for intestinal malrotation in infants with a history of exomphalos repair, especially if presenting with obstructive symptoms.
  • Early diagnosis and surgical management are crucial for favorable outcomes in such rare pediatric surgical emergencies.

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