Leung Edmund, Bramhall Simon, Kumar Prajeesh, Mourad Moustafa, Ahmed Amdad
Wye Valley NHS Trust, Hereford, UK.
Clin Med Insights Gastroenterol. 2016 Jun 12;9:31-3. doi: 10.4137/CGast.S38453. eCollection 2016.
Hernias through the foramen of Winslow are extremely rare, accounting for 0.1% of all abdominal hernias. Delayed diagnosis is often observed, resulting in bowel strangulation and high mortality.
We present a case of a patient with strangulated ileum herniated through the foramen of Winslow. Recent literature review was undertaken on "PubMed" as a search platform using the keywords "foramen of Winslow" and "hernia".
A 66-year-old man presented acutely with severe epigastric pain and vomiting. An emergency computed tomography scan revealed a loop of ileum in the lesser sac. At emergency laparotomy, a herniated loop of ileum that had become strangulated at its entry to the lesser sac via the foramen of Winslow was confirmed. The loop of ileum was reduced but was nonviable, which had to be resected with a primary anastomosis. The patient's postoperative recovery was uneventful.
Herniation through the foramen of Winslow is a difficult diagnosis and must not be missed. Early cross-sectional imaging and surgical intervention are advised in order to reduce morbidity.
通过网膜孔的疝极为罕见，占所有腹外疝的0.1%。常可见诊断延误，导致肠绞窄和高死亡率。
我们报告一例通过网膜孔疝出的绞窄性回肠患者。以“PubMed”为检索平台，使用关键词“网膜孔”和“疝”对近期文献进行了回顾。
一名66岁男性急性出现严重上腹痛和呕吐。急诊计算机断层扫描显示小网膜囊内有一段回肠。急诊剖腹手术时，证实一段疝出的回肠在通过网膜孔进入小网膜囊处发生绞窄。回肠袢复位但已无活力，不得不进行切除并一期吻合。患者术后恢复顺利。
通过网膜孔的疝很难诊断，绝不能漏诊。建议早期进行横断面成像和手术干预以降低发病率。
