[A case of abdominal internal hernia through the foramen of Winslow in a pediatric emergency department].

Abdominal internal hernia is a rare cause of intestinal obstruction in pediatric emergency departments, being the herniation through the foramen of Winslow an exceptional entity (less than 0.5% of the herniae). We report the case of a 15-year-old adolescent male without previous surgical interventions who presented with abdominal pain and vomiting; computed tomography scans showed intestinal obstruction due to an internal hernia through the foramen of Winslow. To reduce the herniated ileum, the patient required surgical intervention with diagnostic laparoscopy, which, due to bad visualization, was changed to supraumbilical midline laparotomy. There was no need to resect the affected ileum as it appeared healthy. We did not perform a preventive technique to reduce the risk of recurrence. Postoperative pelvic collection was conservatively managed with antibiotics. The patient undergoes regular follow-up in the pediatric surgery department.

Caso de hernia interna abdominal a través del hiato de Winslow en urgencias de pediatría / A case of abdominal internal hernia through the foramen of Winslow in a pediatric emergency department

Las hernias internas abdominales son una causa poco frecuente de obstrucción intestinal en las urgencias de pediatría, siendo excepcional la herniación a través del hiato de Winslow (menos del 0,5% de las hernias).Presentamos el caso clínico de un varón adolescente de 15 años sin antecedentes quirúrgicos previos, con clínica de dolor abdominal y vómitos, en el que la tomografía computarizada sugería un cuadro de obstrucción intestinal a causa de hernia interna a nivel del hiato de Winslow. Precisó de intervención quirúrgica mediante laparoscopia explora-dora, reconvertida por mala visualización a laparotomía media supraumbilical, para reducción del asa de íleon herniada. Esta presentaba buen aspecto y no fue necesaria la resección intestinal. No se realizó ninguna técnica preventiva para disminuir el riesgo de recidiva. Postoperatoriamente, el paciente presentó una colección pélvica manejada de manera conservadora con antibióticos. Actualmente se encuentra en seguimiento en consultas externas de cirugía pediátrica. (AU)

Abdominal internal hernia is a rare cause of intestinal obstruction in pediatric emergency departments, being the herniation through the foramen of Winslow an exceptional entity (less than 0.5% of the herniae). We report the case of a 15-year-old adolescent male without previous surgical interventions who presented with abdominal pain and vomiting; computed tomography scans showed intestinal obstruction due to an internal hernia through the foramen of Winslow. To reduce the herniated ileum, the patient required surgical intervention with diagnostic laparoscopy, which, due to bad visualization, was changed to supraumbilical midline laparotomy. There was no need to resect the affected ileum as it appeared healthy. We did not perform a preventive technique to re-duce the risk of recurrence. Postoperative pelvic collection was conservatively managed with antibiotics. The patient undergoes regular follow-up in the pediatric surgery department. (AU)