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Foramen of Winslow internal hernia

Published:April 07, 2022DOI:https://doi.org/10.1016/j.surg.2022.02.018
      A 39-year-old man presented to the emergency department with a 3-day history of worsening abdominal pain, nausea, and vomiting. He had no abdominal surgical history. He was afebrile, normotensive at 125/70 mm Hg, tachycardic at 130 beats per minute, and mildly tachypnoeic at 22 breaths per minute. On examination, his abdomen was diffusely tender with guarding but no evidence of peritonism. He had an elevated lactate of 3 mmol/L and normal inflammatory markers. Computed tomography (CT) of the abdomen and pelvis was performed. On review of the imaging (Figure 1), what diagnosis explains the patient’s acute presentation?
      • A)
        Paraduodenal hernia
      • B)
        Littre hernia
      • C)
        Foramen of Winslow hernia
      • D)
        Pericecal hernia
      Figure thumbnail gr1
      Figure 1Coronal contrast-enhanced CT demonstrates a foramen of Winslow hernia with small bowel present in the lesser sac.
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