Presentation
55 year old female with epigastric pain.
Patient Data
There is an abnormal position of the cecum 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 cecum into the lesser sac. No small bowel obstruction.
Case Discussion
The patient went for laparoscopy with the mobile cecum no longer present within the lesser sac. Uncomplicated cecopexy was performed.
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