PMC8294840_01
Computed tomographic scan of the abdomen and pelvis revealing cecal bascule herniation through the Foramen of Winslow.
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A computed tomography (CT) scan of her abdomen and pelvis revealed a right internal hernia containing cecal bascule herniation through the foramen of Winslow into the lesser sac, concerning for a closed-loop obstruction (Figure 1).
A - Intraoperative findings highlighting cecal herniation through the Foramen of Winslow. The appendix is noted in the right upper quadrant near the gallbladder. The ileum and transverse colon are shown traversing the foramen of Winslow. There is no evidence of the cecum; B - Intraoperative findings post-reduction of cecal bascule herniation through Foramen of Winslow. The cecum and right colon appeared viable.
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After fixed retractors were placed, the appendix was noted to be in the right upper quadrant near the gallbladder and liver edge (Figure 2A). Adhesions were lysed and the hernia sac was partially excised facilitating reduction of the cecal bascule (Figure 2B). The right colon mesentery was noted to be highly redundant (Figure 2B).