Foramen of Winslow Hernia
Small bowel obstruction is a common cause of surgical admission, a minority (0.08%) of which is caused by Foramen of Winslow hernia (FOWH). This entity can be particularly difficult to diagnose, and have been associated with high mortality rates in former years. With the development of accessible computer tomography (CT) earlier diagnosis can be achieved, resulting in better outcomes. The conjunction of FOWH and Meckel’s diverticulum has been reported in the literature, however as a rarity. In this case report, a 76-year-old gentleman presented to our emergency department with features of small bowel obstruction (SBO) and found to have a Meckel’s diverticulum herniating through FOW as a cause of his SBO.
A 76yo patient presented to the emergency department with a one-day history of obstructive symptoms associated with central abdominal pain. His medical background consisted of ischaemic heart disease (previous Coronary Artery Bypass Graft surgery), dyslipidaemia, melanoma excision, open hernia repair and open appendicectomy. An Abdominal CT was performed, and it showed a FOWH. He was then taken to theatre for a laparoscopic reduction of small bowel obstruction. Intraoperatively, a Meckel’s diverticulum herniated through the Epiploic foramen causing the SBO was identified. Decision was made to perform a diverticulectomy; in a tangential fashion. This was performed using a 60mm laparoscopic GIA stapler. The patient had an uneventful postoperative recovery, being discharged from hospital D4 post procedure. The histopathology was reviewed and it confirmed normal histology without ectopic tissues.
Maria Corbetta is a Research Fellow at Hunter New England Health District in Newcastle, Australia. With a career of over 10 years in surgical roles, Maria has been working for the Australian Health workforce since 2015, where she has been pursuing a career in General Surgery. She is a passionate surgical trainee, with interest in advanced laparoscopic surgery and surgical oncology.