PMC9214427_01
(A) Axial section through the upper abdomen showing the dilated small bowel. (B) Coronal section demonstrating the dilated small bowel and the hernia through the foramen of Winslow.
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F1
A loop of bowel was identified to be extending into the lesser sac through the foramen of Winslow, and there was an abrupt transition point as the small bowel entered and exited the foramen of Winslow (figure 1A, B).
A diagram of the foramen of Winslow hernia in this patient.
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F2
These findings were concerning for an internal hernia through the foramen of Winslow (figure 2). Anatomically, it is defined by the free border of the hepatoduodenal ligament anteriorly, the inferior vena cava covered by the peritoneum posteriorly, the caudate lobe superiorly, and the first portion of the duodenum and the hepatic artery inferiorly (figure 2).
PMC9214427_02
Intraoperative image. Laparoscopic instrument demonstrating the location of the internal hernia where the bowel was reduced out of.
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F3
Once the hernia was reduced we were able to identify the defect, as shown in figure 3.