Small bowel obstruction due to herniation through the foramen of Winslow in an elderly patient: a case report

Herniation through the foramen of Winslow is a rare internal hernia and an uncommon cause of intestinal obstruction. An 88-year-old man presented with epigastric pain, nausea, and vomiting for 2 days without previous abdominal surgery. Physical examination showed mild abdominal distension without peritoneal signs. Computed tomography demonstrated dilated small bowel loops within the lesser sac behind the stomach, suggesting herniation through the foramen of Winslow. Emergency laparotomy confirmed herniation of the ileum and cecum into the lesser sac. The bowel was congested but viable and was reduced without resection. Because of excessive mobility of the right colon, the cecum was fixed to the abdominal wall. The postoperative course was uneventful, and the patient was discharged in stable condition. Early diagnosis and prompt surgical intervention are essential for favorable outcomes.