Laparoscopic surgery in a patient with foramen of Winslow hernia due to large uterine fibroids: a case report and literature review

Background Foramen of Winslow hernia (FWH) is a rare but emergent condition caused by an increase in the foramen diameter, visceral mobility, and intra-abdominal pressure. To the best of our knowledge, this is the first study to report a case of FWH secondary to large uterine fibroids that was successfully treated with laparoscopic surgery. Case presentation A 52-year-old woman with large uterine fibroids was diagnosed with FWH. Because of the absence of signs of bowel ischemia and peritonitis, we performed an elective laparoscopic surgery through a 5-port system after bowel decompression using a long intestinal tube. Although foramen of Winslow closure was not performed, her postoperative course was uneventful. Conclusions Laparoscopic surgery for FWH is considered an extremely effective surgical treatment option because of its safety and efficacy in performing delicate procedures (such as adhesiolysis) with a good magnified field of view.

A case of volvulus of the small intestine with chylous ascites in which strangulation was successfully relieved using a long intestinal tube: A case report

Background:Chylous ascites has been uncommonly observed with bowel obstruction. This unusual phenomenon may be secondary to various disease processes with a correct diagnosis seldom made preoperatively. Case presentation: The patient was a 64-year-old man with a medical history of distal gastrectomy for gastric cancer over 30 years ago. We diagnosed him with internal volvulus by several examinations and decided to perform emergency laparotomy. His abdominal pain improved markedly after inserting a long intestinal tube. At laparotomy, there was a large amount of chylous ascites in the abdomen. Despite an edematous small intestine with prominent lymphatic vessels, the cause of the volvulus was unclear, and there was also no evidence of ischemic change in the small intestine. A biochemical analysis of the peritoneal fluid revealed elevated values of triglyceride levels. Conclusion:We experienced a case of volvulus of the small intestine with chylous ascites in which strangulation was successfully relieved using a long intestinal tube.