Internal herniation of caecum into lesser sac

Case contributed by Dr Kenny Sim

Presentation

55 year old female with epigastric pain.

Patient Data

Age: 55 years old
Gender: Female

There is an abnormal position of the caecum which passes through the foramen of Winslow to lie within the lesser sac. The foramen of Winslow is widened with the main portal vein partially effaced by the adjacent large bowel. Both the terminal ileum and appendix have a normal appearance with the appendix lying outside of the lesser sac. No small bowel obstruction.

There is a small volume of free intra-vesical gas, with no IDC and preservation of the fat plane around the bladder. 3.4 cm ovoid hypodense right adnexal lesion.

Conclusion:

Internal herniation of the caecum into the lesser sac. No small bowel obstruction.

Case Discussion

The patient went for laparoscopy with the mobile caecum no longer present within the lesser sac. Uncomplicated caecopexy was performed.

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Case information

rID: 44796
Case created: 4th May 2016
Last edited: 18th May 2016
Inclusion in quiz mode: Included

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