title: Rare cause of acute pain in the left upper abdominal quadrant.
abstract: We report a case of a 45-year-old man with acute pain in the left upper abdominal quadrant. Extensive diagnostic workup remained inconclusive. An exploratory laparotomy revealed herniation of the entire ascending colon, together with a part of the terminal ileum through the foramen of Winslow into the bursa omentalis. The internal hernia was further complicated by a perforated appendicitis within the bursa, explaining the acuteness of the symptoms. Reduction of the hernia, appendectomy and colopexy were performed consequently. This would be the first reported case of a perforated appendicitis within the lesser sack.
authors.affiliation: Department of Surgery and Centre of Minimally Invasive Surgery, Hanover Hospital (Siloah), Roesebeckstrasse 15, 30449, Hanover, Germany. kanellosd@yahoo.com
authors.forename: D
authors.initials: D
authors.lastname: Kanellos
authors.forename: F
authors.initials: F
authors.lastname: Kockerling
authors.forename: K T
authors.initials: KT
authors.lastname: Moesta
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D001064:Appendicitis / Q000150:complications* / Q000601:surgery; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006547:Hernia / Q000150:complications* / Q000175:diagnosis; D059685:Herniorrhaphy; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged