Foramen of Winslow hernia

Area of Science:

• Gastroenterology
• Surgical Anatomy
• Abdominal Imaging

Background:

• Internal hernias, particularly through the foramen of Winslow, are uncommon causes of bowel obstruction.
• Caecal herniation represents a specific and often challenging subset of internal hernias.
• Understanding the anatomical pathways is critical for diagnosis and surgical management.

Observation:

• Presents two cases of caecal herniation diagnosed during laparotomy.
• Highlights that clinical presentation and plain abdominal radiography can suggest the diagnosis.
• Emphasizes the diagnostic utility of imaging in suspected internal hernias.

Findings:

• Diagnosis was confirmed intraoperatively via laparotomy in both presented cases.
• Clinical features and plain abdominal X-rays were identified as potentially pre-operative diagnostic clues.
• The rarity of this condition can delay diagnosis.

Implications:

• Early surgical intervention is paramount for successful outcomes.
• Prompt operative management is essential to prevent bowel strangulation and associated high mortality.
• Increased awareness and diagnostic vigilance for internal hernias are necessary in surgical practice.