Y. Saida et al.: Winslow’s Foraminal and Lesser Omental Hernia
547
7. Hatashi Y, Iguma T, Gotou Y, Uchiyama M (1985) Two cases of
internal herniation through the foramen of Winslow (in Japa-
nese). Rinsho Geka (J Clin Surg) 40:1767–1769
both reported. The fact that 4 of the 10 cases were
complicated with a greater omental foraminal hernia
suggests the presence of congenital abnormalities. Un-
fortunately, establishing a preoperative diagnosis is dif-
ficult, although one report of a foraminal hernia being
diagnosed by CT scan21 has been reported. All cases in
Japan have thus far been diagnosed intraoperatively
after suspicion of an acute abdomen or ileus; therefore,
the possibility of an internal hernia should be consid-
ered during surgery for ileus. The procedure for treating
hernias traversing the lesser omentum is nearly identi-
cal to that for treating Winslow’s foraminal henrias. In
all except the report by Kikuchi et al.,18 suturing of the
defects was described and no postoperative complica-
tions or deaths were reported. Therefore, appropriate
surgical treatment for hernias through Winslow’s fora-
men and defects of the lesser omentum can result in an
entirely satisfactory outcome.
In conclusion, the case report presented herein de-
scribed a Winslow’s foraminal hernia complicated by a
lesser omental traversing hernia. Both types of hernia
are rare, and their causes are uncertain. Because estab-
lishing a preoperative diagnosis is difficult, surgeons
must be mindful of the possibility of an internal hernia
when treating ileus in a patient without any history of
abdominal surgery.
8. Shimizu M, Ohshima Y, Watanabe R, Matsui K, Miyauchi K,
Nishi Y, Morise M, Egashira K, Nakamura H, Kayama H (1991)
A case of hernia through the foramen of Winslow (in Japanese).
Nihon Kyukyu Igakukaizasshi (J Jpn Assoc Acute Med) 2:377
9. Yoshida K, Hirano T, Kusano H, Nishida T, Hisamatu T, Shimizu
T, Nakagoshi T, Miura T, Tomita M (1992) Herniation through
the foramen of Winslow (in Japanese). Fukubu Kyukyu-
shinryouno Shinpo (Prog Acute Abdom Med) 12:569–573
10. Tran TL, Pitt PC (1989) Hernia through the foramen of Winslow.
A report of two cases with emphasis on plain film interpretation.
Clin Radiol 40:264–266
11. Richardson JB, Anastopoulos HA (1981) Hernia through the
foramen of Winslow. MD State Med J 30:56–59
12. Yamazaki Y, Isohashi T, Ookawa H, Takahashi K (1967) Two
cases of intestinal obstruction due to a hernia traversing the lesser
sac (in Japanese). J Jpn Surg Soc 68:303
13. Fukagawa H, Taniguchi T, Watanabe M, Hanaya Y, Yokoyama S,
Yokoyama I, Arai T, Yamada Y, Saitou T (1982) A case of
internal hernia caused by abdominal foramen of the lesser omen-
tum (in Japanese). Rinsho Geka (J Clin Surg) 37:1287–1289
14. Suenaga T, Baba K, Toshinaga R (1987) A case of internal hernia
through the defect of the greater and lesser omentum (in Japa-
nese). Nihon Shoukakigeka Gakkaizasshi (Jpn J Gastrol Surg)
20:486
15. Horikoshi M, Nakamura S, Fujii T, Asanuma K, Ishii N (1988)
Two cases of internal hernia (in Japanese). Nihondaigaku
Igakukaizasshi (J Nihon Univ Med Assoc) 47:94
16. Yasuda S, Inatsugi N, Sakurai T, Nakamura H, Hashimoto T,
Shiratori T (1989) A case of intestinal obstruction due to a hernia
traversing the lesser sac. Jpn J Surg 19:70–73
17. Tagami K, Kuroe K, Numano M, Tabamura K, Watanabe A
(1990) A case of internal hernia through the defect of the greater
and lesser omentum (in Japanese). Nihon Shoukakigeka
Gakkaizasshi (Jpn J Gastrol Surg) 23:213
References
18. Kikuchi Y, Ando Y, Yoshida T, Tsuchiya A, Abe R (1995) A case
of lesser omental hernia (in Japanese with English abstract).
Nihon Rinshogeka Gakkaizasshi (J Jpn Surg Assoc) 56:1446–
1449
1. Takahashi H, Nagai Y (1980) Ileus due to the internal hernia (in
Japanese with English abstract). Shoni Geka (Jap J Pediatr Surg)
12:447–453
2. Ikeuchi J, Kubo H, Iwabuchi S, Nagao B (1984) Internal hernia
(in Japanese). In: Mutoh T (ed) Geka mook ileus. Kanehara,
Tokyo, pp 71–79
3. Funada Y, Nakano G, Uchida Y (1999) A case of hernia through
the foramen of Winslow (in Japanese with English abstract).
Nihon Fukubukyukyu Igakukaizasshi (J Abdom Emerg Med)
1:81–85
4. Takamatsu S (1953) A case of intestinal obstruction due to a
lesser sac hernia (in Japanese). Geka (Surgery) 15:186–188
5. Murata Y, Yoshikawa T (1962) A case of hernia through the
foramen of Winslow (in Japanese). Rinsho Houshasen (Jpn J Clin
Radiol) 7:451–455
19. Kitagishi H, Takahashi H, Maeda S, Maruyama K, Maruyama J,
Sakata I (1996) A case of hernia traversing the lesser sac due to
bacterial food poisoning (in Japanese). Nihon Fukubukyukyu
Igakukaizasshi (J Abdom Emerg Med) 16:780
20. Fujita N, Endoh Y, Onouchi M, Hasebe M, Kobayashi K (1996) A
case of intestinal obstruction due to a lesser sac hernia traversing
the greater omentum and post-gastric space (in Japanese). Nihon
Rinshogeka Gakkaizasshi (J Jpn Surg Assoc) 57:402
21. Tran TL, Regan F, Al-Kutoubi MAO (1991) Computed tomogra-
phy of lesser sac hernia though the gastrohepatic omentum. Br J
Radiol 64:372–374
22. Gants RT, Ryle JW (1953) Herniation of stomach and colon into
omental bursa through a defect in the gastrohepatic ligament.
Ann Surg 137:285–288
6. Ohkuma R, Miyazaki K (1977) Hernia through the foramen of
Winslow. Jpn J Surg 7:151–157