Lesser sac hernia

Last revised by Vikas Shah on 19 Jan 2022

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

Lesser sac hernias are rare, accounting for <0.1% of abdominal hernias and 8% of internal hernias 1,2.

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

  • gas-filled loops of small bowel in the upper abdomen
  • 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

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

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