Closure of normal and abnormal abdominal openings part II: epiploic foramen and mesenteric rents

Epiploic foramen

The epiploic foramen(EF) is defined as“the opening from the greater peritoneal sac to the omental vestibule that passes between the caudal vena cavadorsally,theportalveinthatisincludedinthehepatoduodenalligamentventrally,thecaudallobeofthelivercranially,andthepancreascaudally”.Thisslit-like opening is called the “Winslow foramen” in human literature, named after the French-Danish doctor and anatomist Jacob alias Jacques-Bénigne Winslow (1669-1760) who first described this enigmatic structure.

Large case series of intestinal herniation through the foramen of Winslow are lacking in human literature as this condition is very uncommon in man.Due to the lack of recurrent cases in human literature there is some discussion between authors on whether the Winslow foramen should be surgically closed after reduction of entrapped intestines to avoid recurrence of the condition. However, in light of the severity of the condition, closure of the Winslow foramen with sutures at the end of the laparotomic procedure has recently been recommended.

In horses the condition has been called Epiploic foramen entrapment (EFE). This life-threatening condition is much more prevalent in horses compared to humans and other mammalian species and is encountered in about 5 to 8% of the surgically treated equine colic patients.Windsucking/crib-biting has been identified as an important factor related to the development of EFE. Epiploic foramen entrapment has been associated with high rates of morbidity and mortality. [...]