Kharkhach Ayoub, Police Andrea, Mabilia Andrea, Charre Lionel
Department of Viscéral Surgery, Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco.
Department of Visceral and Digestive Surgery, Simone Veil Hospital, Eaubonne, France.
J Surg Case Rep. 2022 Aug 31;2022(8):rjac364. doi: 10.1093/jscr/rjac364. eCollection 2022 Aug.
Internal hernias through the foramen of Winslow are considered as rare events. A 66-year-old female patient presented to our emergency department with epigastric and right upper quadrant pain associated with abdominal distention, nausea and vomiting and signs of shock. A computed tomography scan showed bowel strangulation with distended loops identified within the lesser sac. The diagnosis was confirmed by a midline laparotomy procedure. The ileum, the caecum and the ascending colon were found to herniate into the foramen of Winslow. A right hemicolectomy with a resection of the necrotic segment was performed. The patient recovered well postoperatively and was discharged on 10th day after surgery. The diagnosis and management of this rare disease remains challenging. Cross-sectional imaging with reconstruction is considered as the diagnostic modality of choice. Moreover, right hemicolectomy is a preferred procedure in order to decrease the rate of recurrence.
通过网膜孔的内疝被认为是罕见事件。一名66岁女性患者因上腹部和右上腹疼痛伴腹胀、恶心、呕吐及休克体征就诊于我院急诊科。计算机断层扫描显示小网膜囊内肠管绞窄伴肠袢扩张。经中线剖腹手术确诊。发现回肠、盲肠和升结肠疝入网膜孔。行右半结肠切除术并切除坏死段。患者术后恢复良好,术后第10天出院。这种罕见疾病的诊断和治疗仍然具有挑战性。重建的横断面成像被认为是首选的诊断方式。此外,右半结肠切除术是降低复发率的首选手术。