Herniation of the colon through the foramen of Winslow—A case report

• Herniation is rare and diagnostic delay increases mortality and morbidity.
• Patients present with nonspecific acute abdominal pain.
• Computed tomography helps early diagnosis and could thereby prevent bowel ischemia.
• Herniation can be reversed laparoscopically without bowel resection in case of early diagnosis.

IntroductionHerniation of the bowel through the foramen of Winslow is a rare condition presenting with acute abdominal pain. Diagnostic delay often results in high morbidity and mortality.Case presentationA patient presented with right sided acute abdominal pain. Computed tomography showed herniation of the ascending colon through the foramen of Winslow which could be reversed laparoscopically without the need for bowel resection. There were no postoperative complications and no recurrences have occurred to date.DiscussionBowel herniation through the foramen of Winslow is very rare, comprising only 8% of all internal herniations. Historically, the majority of cases was diagnosed intra-operatively and bowel resection was necessary because of ischemia. With the introduction of computed tomography, the diagnosis can be made earlier, possibly resulting in a lower morbidity and mortality rate.ConclusionHerniation through the foramen of Winslow is a rare condition. Patients will present with sudden onset abdominal pain. Early imaging helps to recognize the diagnosis and could prevent bowel ischemia.