Hernia Through the Foramen of Winslow: a Rare Form of Internal Hernia and a Diagnostic Dilemma

Abstract

Internal hernia through the foramen of Winslow is extremely rare. Since its first description by Blandin in 1834, not many cases have been reported. They often have vague symptoms, but intestinal obstruction is inevitable. Delayed diagnosis results in strangulation of bowel and high mortality. We present a case of 24-year-old male who presented with acute, severe, diffuse abdominal pain and vomiting for 1 day, and on evaluation diagnosed to have closed loop obstruction with internal hernia through the foramen of Winslow. Emergency exploratory laparotomy done, contents reduced, and repair of hernia done. The foramen of Winslow hernia constitutes less than 0.1% of all abdominal hernias. It is difficult to diagnose in view of nonspecific presentation often resulting in bowel ischemia and mandating the need of bowel resection. Early cross-sectional imaging and surgical intervention are advised in order to reduce morbidity and mortality.