Epiploic Foramen Research Articles

Hernia through the foramen of winslow. A report of two cases with emphasis on plain film interpretation

Two patients with hernia through the foramen of Winslow are described. The diagnosis, based on plain film findings, was established pre-operatively in one case. The plain radiographic features of this condition and the differential diagnosis are discussed.

Anatomical terminology/clinical terminology

AbstractNearly 100 years ago, the first formal attempt was made to standardize anatomical nomenclature. As Latin was the only language that many countries had in common, it formed the basis of anatomical terminology. It is common and accepted practice to translate the Latin terms into the language of the country concerned. As anatomical terminology is complex, it becomes very difficult when two or more widely accepted terms are used for the same structure (e.g., epiploic foramen and foramen of Winslow). In 1950, an International Anatomical Nomenclature Committee was formed to standardize anatomical terminology. It produced a book called Nomina Anatomica, which is now in its fifth edition. Many physicians with whom medical and other students are associated are unfamiliar with this new terminology. As a result they use terms, often synonyms, with which they are familiar. Members of the American Association of Clinical Anatomists are urged to use the terminology recommended in the Nomina Anatomica;, fifth edition, and to encourage their clinical colleagues to adopt the new terminology by giving both terms as follows: internal thoracic artery, (formerly called the internal mammary artery). In due course, anatomists and clinicians will be using the same terms and medical and other students will be most grateful.

The portacaval space: CT with MR correlation.

Between the portal vein and the inferior vena cava lies a small space that may be occupied by multiple anatomic structures including the caudate and papillary processes of the caudate lobe of the liver, portacaval lymph nodes, replaced or accessory right hepatic arteries, posterosuperior pancreaticoduodenal vessels, the cystic duct, and the epiploic foramen to the lesser sac. The sectional anatomy of these structures is illustrated in this paper with particular emphasis on the portacaval nodes. Unlike the adjacent celiac lymph nodes, portacaval nodes appear rectangular or elliptical on transverse sections and may measure up to 1.3 cm in anteroposterior dimension. They may mimic portions of the pancreas, liver, or biliary tract on sectional images.

Die Entwicklung der Bursa omentalis des Schafes und ihre Bedeutung für die Topographie der Bauchhöhle*

AbstractThe hypotheses for the development of the omental bursa (rotation of the stomach, formation of folds, invagination of the celomic epithelium, formation of a recess) do not agree with each other. On 31 sheep embryos (4–50 mm CRL; 16–44 days old) the formation of the omental bursa was studied using serial sections and three‐dimensional reconstructions. The primary epiploic foramen induces fusion and enlargement of mesenchymal clefts on the right side of the foregut, producing recesses. The latter, after elongation of the dorsal and ventral mesogastria, give rise to the omental bursae.

Herniation of the gallbladder through the epiploic foramen into the lesser sac.

Herniation of the gallbladder through the epiploic foramen into the lesser sac.

THE RADIOLOGIC SIGNS OF DISEASE IN THE LESSER PERITONEAL SAC

The contour of the lesser peritoneal sac is readily identified on supine and erect plain films of the abdomen if the cavity contains moderate or large amounts of gas. Small amounts of gas or loculated collections cannot be identified as being in the lesser peritoneal sac without lateral views of the abdomen after opacification of the stomach. Almost always, midline subdiaphragmatic gas collections will be shown to be intraperitoneal. Fluid collections in the lesser sac displace the stomach anteriorly, upward and to the right. Typically there is a large left-sided soft tissue density with an oblique lower border that runs laterally and downward. Abscesses originating in the pancreas may fill the lesser sac with multiple small gas collections or, if coalescent, with long retrogastric air-fluid levels. The distal ileum or right side of the colon may herniate through the foramen of Winslow into the lesser peritoneal sac. The small intestine proximally shows the signs of mechanical obstruction. The herniated segment usually undergoes obstruction of the closed-loop type. Often a characteristic extrinsic obstruction of the distal limb of the hepatic flexure is produced when the herniating loop of small intestine crosses the colon on its way to the epiploic foramen.

Hernia through the foramen of winslow: Secondary rupture through the gastro-hepatic omentum

Hernia through the foramen of winslow: Secondary rupture through the gastro-hepatic omentum

PERITONEAL SUPPORTS—(LIGAMENTUM PERITONEI.)

The hepatic artery produces only a slight elevation of peritoneum until it reaches the hepato-duodenal ligament, whence it aids in giving distinct outline to the border of Winslow's foramen on the right. By opening an adult cadaver, well prepared for inspection, and then carefully incising the gastro-colic omentum, one can see with perfection the shape and form of the left opening of Winslow into the lesser omental bag. To obtain the best view of Winslow's foramen, however, the ribs on both sides should be removed and the stomach lifted well up. Winslow's foramen will then be seen to have a distinct oval form as seen from inside the lesser bag, whose circumference is nearly all produced by peritoneal folds projected by the gastric and hepatic arteries. The splenic artery, I must say, contrary to some anatomists, does not run into the gastro-splenic ligament until it nears its termination. Beginning at

Clinical Lecture ON HERNIA INTO THE FORAMEN OF WINSLOW.

Clinical Lecture ON HERNIA INTO THE FORAMEN OF WINSLOW.