title: Laparoscopic reduction of an internal hernia of transverse colon through the foramen of Winslow.
abstract: Large bowel obstruction by incarceration in the lesser sac through the foramen of Winslow is exceedingly rare and often associated with nonviable bowel at the time of operation according to older reports. In modern times, widespread availability of computed tomography (CT) for investigation of the acute abdomen may decrease the necessity of bowel resection in these cases. Here, we present a case of laparoscopic reduction of viable transverse colon from the lesser sac in a young woman. With the diagnosis suggested by CT, we were able to approach the case with two five millimeter working ports and 1 optical port, reducing the hernia by means of traction on the distal limb of transverse colon. The patient recovered well and was discharged on day 4 postoperative after bowel movement was achieved. Internal hernia represents one of the few cases in which laparoscopy may be the preferred approach to large bowel obstruction.
authors.affiliation: Royal North Shore Hospital, Sydney, New South Wales, Australia. adclough@bigpond.com
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Clough
authors.forename: Garett S
authors.initials: GS
authors.lastname: Smith
authors.forename: Steven
authors.initials: S
authors.lastname: Leibman
mesh_terms: D000328:Adult; D044684:Colon, Transverse; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006547:Hernia / Q000000981:diagnostic imaging*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010529:Peritoneal Cavity / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed