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Caecal volvulus in a foramen of Winslow hernia
  1. Sandra L Carpenter1,2,
  2. Jacob Campbell1,2 and
  3. Vijay Jayaraman1,2
  1. 1Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, Connecticut, USA
  2. 2Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, USA
  1. Correspondence to Sandra L Carpenter; carpenter{at}uchc.edu

Abstract

Caecal herniation through the foramen of Winslow is an uncommon presentation of internal hernia with an estimated overall incidence of 0.02%. Even rarer still is a caecal volvulus strangulated in the lesser sac, a surgical emergency seldom described in the literature. A woman in her 70s presented with a 1-day history of acute-onset right upper quadrant and epigastric pain associated with nausea and vomiting. Prompt CT imaging revealed caecal volvulus within a foramen of Winslow hernia. The diagnosis was confirmed by laparotomy. A right hemicolectomy was performed and the foraminal defect was closed. We identified eight case reports of this rare entity published within the last 30 years. Our patient was managed in a similar manner and recovered without complication, providing further guidance for the operative management of caecal volvulus in the foramen of Winslow.

  • surgery
  • general surgery

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Footnotes

  • Contributors SLC is a medical student at the University of Connecticut School of Medicine in Farmington, Connecticut. She contributed to literature search, writing, critical revision and submission. VJ, MD, FACS, is an acute care surgeon at Saint Francis Hospital in Hartford, Connecticut. He contributed to conception of the case report, critical revision and final approval of the submission. JC, DO, is a paediatric surgery fellow at Connecticut Children’s Medical Center in Hartford, Connecticut. At the time of this research, he was a general surgery resident at the University of Connecticut School of Medicine in Farmington, Connecticut. He contributed to critical revision.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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