Mansoor Saira Mauland, Grandahl Ole Jacob, Fetveit Torunn
Tidsskr Nor Laegeforen. 2022 Jan 31;142(2). doi: 10.4045/tidsskr.21.0326. Print 2022 Feb 1.
Internal herniation through the foramen of Winslow is a rare cause of bowel obstruction. The presented case illustrates this condition and considerations made regarding treatment.
An elderly woman was admitted to the hospital with sudden onset of epigastric pain and vomiting. Blood tests were normal except for a lactate value of 2.5 mmol/L (normal value < 1.8). Computer tomography showed internal herniation of the caecum through the foramen of Winslow. Initial treatment with intravenous fluids, a nasogastric tube and fasting did not resolve the bowel obstruction. The herniated caecum was laparoscopically reduced, and there were no signs of intestinal ischaemia.
Internal herniation through the foramen of Winslow is rare. There are no evidence-based guidelines on treatment, or on prophylactic measures to prevent recurrence. Both laparoscopic and open surgical approaches have been reported, with or without closure of the foramen. There is little documentation on recurrence rates.
通过网膜孔发生内疝是肠梗阻的罕见原因。本文介绍的病例说明了这种情况以及关于治疗的考虑因素。
一名老年女性因突发上腹部疼痛和呕吐入院。除乳酸值为2.5 mmol/L（正常值<1.8）外，血液检查均正常。计算机断层扫描显示盲肠通过网膜孔发生内疝。最初采用静脉输液、鼻胃管和禁食治疗，但肠梗阻未得到缓解。通过腹腔镜将疝出的盲肠复位，未发现肠缺血迹象。
通过网膜孔发生内疝很罕见。目前尚无基于证据的治疗指南，也没有预防复发的预防性措施指南。腹腔镜和开放手术方法均有报道，手术时可选择关闭或不关闭网膜孔。关于复发率的文献报道很少。
