Caecal Volvulus in a Foramen of Winslow Hernia Masquerading as Biliary Colic

Internal hernias account for a minority of cases of intestinal obstruction. Within this group, internal hernias through the foramen of Winslow (FW) are an even rarer subcategory with a paucity of cases reported in the literature. We present a case of a 48-year-old female presenting with right upper quadrant pain akin to biliary colic with sonographic evidence of cholelithiasis. Her symptoms swiftly worsened, and she re-presented with symptoms of bowel obstruction. She was subsequently found to have a caecal volvulus herniating through the FW on computed tomography (CT). She underwent an emergency laparotomy to reduce the hernia and prevent further recurrence, which highlighted the importance of a comprehensive history and the increasing role of cross-sectional imaging in emergency surgery.