Khan, Fazal W

Abstract Internal herniation through the foramen of Winslow is one of the rarest types of hernia. As signs and symptoms can be quite generalized, prompt identification can prove difficult, leading to increased morbidity and mortality. The majority of reported cases of foramen of Winslow herniation result in obstruction of either the small or large bowel requiring operative intervention. As they are so rare, there is no established treatment algorithm for foramen of Winslow hernias. We present here a unique case of cecal herniation through the foramen of Winslow resulting in biliary compression and acute cholecystitis without bowel obstruction that was managed with laparoscopic cholecystectomy and right hemicolectomy.

Cardiac fistulas present diagnostical and therapeutical challenges due to their variability in size, shape and pathway. Three-dimensional printing is increasingly used to provide a tactile representation that aids in preoperative planning and patient education. We present the case of a female in her 60s who developed a fistula between the left ventricle, right atrium and coronary sinus 2 years after bioprosthetic valve replacement. We used three-dimensional modelling to better understand her cardiac anatomy and optimise our surgical approach. She was discharged home without deficit following an uneventful postoperative course. Three-dimensional printing can improve patient care through tangible demonstration, preoperative planning and trainee education.