Lesser sac hernia

Lesser sac hernias (alternative plural: herniae) are a type of internal hernia, where abdominal contents protrude through the foramen of Winslow, hence they are also known as foramen of Winslow hernia.

Epidemiology

Lesser sac hernias are rare, accounting for <0.1% of abdominal hernias and 8% of internal hernias .

Risk factors

Pathology

Typically contains small bowel only (~67%) but may also contain cecum/ascending colon and less commonly transverse colongallbladder, or omentum.

Radiographic features

Plain radiograph
  • gas-filled loops of small bowel in the upper abdomen
CT
  • mesenteric fat/vessels posterior to portal vein, common bile duct, hepatic artery and anterior to the inferior vena cava
  • mesenteric vessels passing into the lesser sac via the foramen of Winslow
  • gas and/or fluid in the lesser sac with bird beak sign towards the foramen of Winslow
  • abnormal cecal position

Differential diagnosis

History and Etymology

It is named after Jacques Benigne Winslow (1669-1760), a Danish-born French anatomist.

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