Cecal internal hernia through Winslow's hiatus:
Laparoscopic resolution
DOI:
https://doi.org/10.31053/1853.0605.v81.n3.44555Keywords:
internal hernia, cecum, laparoscopy, ColectomyAbstract
Background: Hernia through Winslow's hiatus, known as Blandin’s hernia, a rare but potentially life-threatening condition, represents a diagnostic and therapeutic challenge. This case report describes a successful laparoscopic approach to a cecum hernia through the foramen of Winslow in a 63-year-old female.
Case Presentation: The patient presented with 24 hours of abdominal pain and nausea. Abdominal CT scan revealed a herniated cecum and terminal ileum compressing the gastric chamber and portal vein, leading to periportal edema. Laparoscopic right colectomy was performed after successful colon content evacuation via the greater gastric curvature to facilitate reduction. This was done to aid in reduction, as there were indications of non-viability in the right colon. The procedure unfolded without complications.
The patient developed postoperative abdominal collections requiring percutaneous drainage but recovered well and was discharged within two weeks.
Conclusion: This case highlights the value of laparoscopy in managing foramen of Winslow hernias, offering minimally invasive benefits. Early diagnosis through imaging tools like CT is crucial for prompt surgical intervention and preventing complications like intestinal ischemia or perforation.
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References
Ezanno AC, Lamboley JL, Peroux E. Internal hernia of Winslow’s foramen. J Visc Surg [Internet]. 2023 Oct;160(5):392–4. Available from: http://dx.doi.org/10.1016/j.jviscsurg.2023.06.009
Buisset C, Aziz S, Bilbault F, Hoch G, Nesseler JP, Johann M. Laparoscopic management of an ascending colon hernia through the foramen of Winslow. Journal of surgical case reports [Internet]. 2020 Sep 8 [cited 2023 Dec 13];2020(9). Available from: https://pubmed.ncbi.nlm.nih.gov/32922726/
Moris D, Tsilimigras DI, Yerokun B, Seymour KA, Guerron AD, Fong PA, et al. Foramen of Winslow Hernia: a Review of the Literature Highlighting the Role of Laparoscopy. J Gastrointest Surg [Internet]. 2019 Oct [cited 2023 Dec 13];23(10). Available from: https://pubmed.ncbi.nlm.nih.gov/31420858/
Carpenter SL, Campbell J, Jayaraman V. Caecal volvulus in a foramen of Winslow hernia. BMJ Case Rep [Internet]. 2022 Mar 2 [cited 2023 Dec 13];15(3). Available from: https://pubmed.ncbi.nlm.nih.gov/35236689/
Lanzetta MM, Masserelli A, Addeo G, Cozzi D, Maggialetti N, Danti G, et al. Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings. Acta Biomed [Internet]. 2019 Apr 24 [cited 2023 Dec 13];90(5-S). Available from: https://pubmed.ncbi.nlm.nih.gov/31085971/
Puig CA, Lillegard JB, Fisher JE, Schiller HJ. Hernia of cecum and ascending colon through the foramen of Winslow. Int J Surg Case Rep [Internet]. 2013 [cited 2023 Dec 13];4(10). Available from: https://pubmed.ncbi.nlm.nih.gov/23973900/
Bautista-Álvarez FE, Pérez-Soto RH, Clemente-Gutiérrez U, Hernández-Villegas AC, Sierra-Salazar M. Foramen of Winslow hernia: A rare cause of acute abdomen. Rev Gastroenterol Mex [Internet]. 2020 Jul [cited 2023 Dec 13];85(3). Available from: https://pubmed.ncbi.nlm.nih.gov/31748180/
Luciano E, Hyde R, Solh W, Davis RT, Pacheco F. Internal herniation of the cecum through the foramen of Winslow-a case report. Journal of surgical case reports [Internet]. 2021 Oct 31 [cited 2023 Dec 13];2021(10). Available from: https://pubmed.ncbi.nlm.nih.gov/34733471/
Martin LC, Merkle EM, Thompson WM. Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol [Internet]. 2006 Mar [cited 2023 Dec 13];186(3). Available from: https://pubmed.ncbi.nlm.nih.gov/16498098/
Szczepanski JR, White RZ, Au J. Foramen of Winslow internal hernia. Surgery [Internet]. 2022 Sep;172(3):e27–8. Available from: http://dx.doi.org/10.1016/j.surg.2022.02.018
Harnsberger CR, McLemore EC, Broderick RC, Fuchs HF, Yu PT, Berducci M, et al. Foramen of Winslow hernia: a minimally invasive approach. Surg Endosc [Internet]. 2015 Aug [cited 2023 Dec 13];29(8). Available from: https://pubmed.ncbi.nlm.nih.gov/25361659/
Daher R, Montana L, Abdullah J, d’Alessandro A, Chouillard E. Laparoscopic management of foramen of Winslow incarcerated hernia. Surgical case reports [Internet]. 2016 Dec [cited 2023 Dec 13];2(1). Available from: https://pubmed.ncbi.nlm.nih.gov/26943685/
Van Daele E, Poortmans M, Vierendeels T, Potvlieghe P, Rots W. Herniation through the foramen of Winslow: a laparoscopic approach. Hernia [Internet]. 2011 Aug [cited 2023 Dec 13];15(4). Available from: https://pubmed.ncbi.nlm.nih.gov/20467768/
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