title: Internal Herniation Through Foramen of Winslow: A Diagnosis Not to Be Missed.
abstract: BACKGROUND
  Hernias through the foramen of Winslow are extremely rare, accounting for 0.1% of all abdominal hernias. Delayed diagnosis is often observed, resulting in bowel strangulation and high mortality.
  
  
  METHODS
  We present a case of a patient with strangulated ileum herniated through the foramen of Winslow. Recent literature review was undertaken on "PubMed" as a search platform using the keywords "foramen of Winslow" and "hernia".
  
  
  METHODS
  A 66-year-old man presented acutely with severe epigastric pain and vomiting. An emergency computed tomography scan revealed a loop of ileum in the lesser sac. At emergency laparotomy, a herniated loop of ileum that had become strangulated at its entry to the lesser sac via the foramen of Winslow was confirmed. The loop of ileum was reduced but was nonviable, which had to be resected with a primary anastomosis. The patient's postoperative recovery was uneventful.
  
  
  CONCLUSIONS
  Herniation through the foramen of Winslow is a difficult diagnosis and must not be missed. Early cross-sectional imaging and surgical intervention are advised in order to reduce morbidity.
authors.affiliation: Wye Valley NHS Trust, Hereford, UK.
authors.forename: Edmund
authors.initials: E
authors.lastname: Leung
authors.affiliation: Wye Valley NHS Trust, Hereford, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Bramhall
authors.affiliation: Wye Valley NHS Trust, Hereford, UK.
authors.forename: Prajeesh
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Wye Valley NHS Trust, Hereford, UK.
authors.forename: Moustafa
authors.initials: M
authors.lastname: Mourad
authors.affiliation: Wye Valley NHS Trust, Hereford, UK.
authors.forename: Amdad
authors.initials: A
authors.lastname: Ahmed
keywords: foramen of Winslow; internal herniation; strangulation