Cecal hernia into the lesser sac

Two cases of cecal herniation through the foramen of Winslow into the lesser sac are presented. This unusual and potentially life-threatening form of internal herniation can be diagnosed radiographically on plain abdominal radiographs and barium studies by identifying the cecum lying posterior and medial to the stomach in association with the absence of the cecum in the right lower quadrant of the abdomen. One of the described cases is unique in that the patient was asymptomatic relative to the internal hernia. The other case clearly demonstrates the importance of increased intra-abdominal pressure as a causative factor in foramen of Winslow hernia.