Small bowel herniation through the epiploic foramen reduced laparoscopically.

Abstract

Herniation of intestinal contents through the epiploic foramen is a rare phenomenon. Diagnosis is often missed owing to its non-specific presentation, delaying management and increasing morbidity and mortality. We report a 60-year-old man presenting with symptoms of abdominal pain and total constipation with small bowel dilatation and unclear computed tomography findings. Exploratory laparoscopy revealed terminal ileum herniation through the epiploic foramen. Laparoscopic reduction was performed with no bowel resection required. Postoperative recovery was uneventful with no recurrence. Controversy exists in the literature regarding closure of the foramen to prevent recurrence; however, this carries significant risks. Repeated assessment and early exploration are key in identifying and managing such rare presentations.