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Internal hernia of caecum through the foramen of Winslow
  1. Faez Ayoob,
  2. Rami Michael,
  3. Zachary Chadnick and
  4. Charles Fasanya
  1. General Surgery, Staten Island University Hospital, Staten Island, New York, USA
  1. Correspondence to Dr Zachary Chadnick, zchadnick1{at}


Internal hernias through the foramen of Winslow are very rare. An 80-year-old female patient presented with epigastric and right upper quadrant pain associated with abdominal distention, nausea and vomiting for 1 day. A CT scan showed an internal hernia with terminal ileum and caecum identified within the lesser sac. The diagnosis was confirmed by laparotomy. A right hemicolectomy was performed to prevent further recurrence. We reviewed case reports with the same presentation by searching the Pubmed database using the keywords: ‘foramen Winslow hernia, cecum’. We identified 23 publications. Our review extracted the following information: presentation, anatomical findings, pathological causes and surgical management. Misdiagnosis was common due to the limitations of plain abdominal X-rays. Abdominal CT scan is now the preferred radiological study and is more effective in establishing a diagnosis. Surgical treatment options varied. Right hemicolectomy has emerged as the preferred procedure to decrease the rate of recurrence.

  • surgery
  • general surgery
  • gastrointestinal surgery
  • intensive care
  • adult intensive care

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  • Contributors All authors were responsible for the study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; statistical analysis; administrative, technical or material support and study supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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