Valenziano C P, Howard W B, Criado F J
Am Surg. 1987 May;53(5):254-7.
In 151 years since first described, there have been 112 reported cases of hernia through the foramen of Winslow (HFW). All thus far have described HFW as a primary entity. The case reported appears to be unique with HFW as a surgical complication. HFW is the least common of internal hernias. The primary symptom is pain referred from the herniated organ and the hepatoduodenal ligament. An interesting sign is that the patient is found curled up or stooped over for pain relief. Anatomic factors implicated in HFW are an enlarged epiploic foramen, a floppy cecum and ascending colon, or abnormal length of small bowel mesentery. Tension on these structures causes pain with the torso extended. Distention of bowel in the lesser sac mimics gastric obstruction. Organs herniated are: small bowel (63%); cecum, ascending colon, and terminal ileum (30%); and transverse colon (7%). Of 25 cases reported since 1966, cecal herniation comprised two-thirds. The diagnosis may be made radiologically and the treatment is surgical. The case and a review of the literature are presented with attention to the anatomy. Also provided are the signs and symptoms of this interesting and perplexing diagnosis.
自首次描述以来的151年间，经网膜孔疝（HFW）已有112例报告病例。迄今为止，所有病例均将HFW描述为一种原发性疾病。本文报告的病例似乎很独特，是作为一种手术并发症的经网膜孔疝。经网膜孔疝是最罕见的内疝。主要症状是来自疝出器官和肝十二指肠韧带的牵涉痛。一个有趣的体征是发现患者为缓解疼痛而蜷缩或弯腰。与经网膜孔疝相关的解剖学因素包括网膜孔扩大、盲肠和升结肠松弛或小肠系膜长度异常。这些结构受牵拉会在躯干伸展时引起疼痛。小网膜囊内肠管扩张类似胃梗阻。疝出的器官有：小肠（63%）；盲肠、升结肠和回肠末端（30%）；以及横结肠（7%）。自1966年以来报告的25例病例中，盲肠疝占三分之二。诊断可通过影像学检查做出，治疗为手术治疗。本文介绍了该病例并对文献进行了回顾，重点关注了解剖结构。还介绍了这一有趣且令人困惑的诊断的体征和症状。
