Open AccessA Rare Cause of Obstructive Jaundice: Cecal Herniation through the Foramen of Winslow
Author(s) -
Ivan Welaratne,
Afshin Nasoodi
Publication year - 2018
Publication title -
journal of clinical imaging science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.279
H-Index - 18
eISSN - 2156-7514
pISSN - 2156-5597
DOI - 10.4103/jcis.jcis_12_18
Subject(s) - medicine , jaundice , cecum , epigastric pain , foramen , abdominal pain , internal hernia , hernia , vomiting , surgery , radiology , general surgery , gastroenterology
Internal abdominal hernias are rarely reported in the literature and have a very low rate of preoperative diagnosis. It is even rarer that they present with jaundice. A 59-year-old Caucasian female presented with a short history of jaundice, dark urine, epigastric pain, vomiting, and obstipation. Her liver biochemistry profile revealed a mixed cholestatic/hepatocellular pattern with significantly elevated bilirubin. She urgently underwent abdominal imaging which provided a preoperative diagnosis of internal herniation of the cecum within the lesser sac through the foramen of Winslow. The dilated bowel was compressing the common bile duct explaining the jaundice. This was repaired intraoperatively by anchoring the mobile cecum. In this case, we highlight the importance of maintaining a high index of suspicion for internal herniation on abdominal imaging with clinical evidence of intestinal obstruction. A foramen of Winslow hernia should be further suspected in the presence of jaundice.