Hospital Italiano de Buenos Aires.
Rev Fac Cien Med Univ Nac Cordoba. 2024 Sep 27;81(3):587-597. doi: 10.31053/1853.0605.v81.n3.44555.
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.
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.
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.
经温斯洛裂孔的疝，即布兰丁疝，是一种罕见但潜在危及生命的疾病，这对诊断和治疗构成了挑战。本病例报告描述了一例成功的腹腔镜手术，通过温斯洛裂孔对 63 岁女性的盲肠疝进行治疗。
患者出现腹痛和恶心 24 小时。腹部 CT 扫描显示疝出的盲肠和末端回肠压迫胃腔和门静脉，导致门周水肿。通过大胃曲率成功排空结肠内容物，以促进还纳，随后进行腹腔镜右结肠切除术。由于右结肠有非存活迹象，因此进行了还纳。手术过程顺利，无并发症。患者术后出现腹部积液，需要经皮引流，但恢复良好，两周内出院。
本病例强调了腹腔镜在治疗温斯洛裂孔疝中的价值，具有微创优势。通过 CT 等影像学工具进行早期诊断对于及时手术干预和预防肠缺血或穿孔等并发症至关重要。
