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Approximately 5% of intestinal obstruction cases are caused by internal herniation. Caecal herniation through the foramen of Winslow is considered a rare event. The management of caecal herniation remains challenging due to the lack of literature highlighting this pathology. A 66-year-old woman was admitted with a 24-hour history of epigastric pain radiating to the back. The pain was associated with nausea and vomiting of gastric contents. On examination, the abdomen was soft with mild tenderness but no signs of peritonism or distension. The abdominal x-ray and a computed tomography were in keeping with caecal volvulus and confirmed that the caecum was not in the right iliac fossa. In a midline laparotomy procedure, the ileum, caecum and ascending colon were noted to be herniating into the foramen of Winslow. A right hemicolectomy with a handsewn anastomosis was performed. The foramen of Winslow was not closed. No postoperative complications occurred. A literature review showed a lack of similar cases with no agreed management consensus. The laparotomy approach is comparable to the laparoscopic approach and no caecal herniation recurrence after open/laparoscopic surgical procedures were identified. Awareness of caecal herniation allows early diagnosis and timely surgical management is needed in prevent patient morbidity and mortality.

In der Bestrebung, das Rezidivrisiko zu senken und ein besseres Langzeitergebnis zu erzielen, sind alloplastische Verfahren zum Einsatz gekommen. Die modernen Netze bestehen aus dunneren Filamenten, haben eine hohere Porengrose und sind dehnbar. Das Ziel ist die spannungsfreie Rekonstruktion der betroffenen Beckenbodenkompartimente durch Implantate. Die Implantate konnen ohne Entfernung pelviner Organe verwendet werden und erfordern keine Integritat der pelvinen Faszie oder der Beckenbodenmuskulatur. Die spannungsfreie, sichere Lage der Implantate mit der nahtfreien Positionierung uber die anterioren oder posterioren Implantatarme sowie die grobporige Netzstruktur fuhren zu einem sicheren Halt der Implantate in den entsprechenden Kompartimenten mit der gewunschten Gewebeunterstutzung und Haltefunktion, die den naturlichen Beckenbodenstrukturen verloren gegangen sind. In der immer individuell zu treffenden Therapieentscheidung besitzen konventionelle und netzbasierte Methoden einen Stellenwert.

We have isolated and characterized a polyclonal antibody that recognizes the extracellular matrix glycoprotein laminin. In the developing rat hippocampus, in addition to staining the basal laminae of blood vessels and the glia limitans, this antibody detects a punctate deposit of non-basal lamina laminin that appears transiently, disappearing on E18. The punctate laminin is distributed throughout the hippocampus from the border of the ependyma and the neuropil to the pial surface, but is particularly concentrated in the presumptive molecular layer (marginal zone). Electron microscopy showed that the punctate laminin was in the extracellular space on the surfaces of cell bodies and, more commonly, their processes. In double-labelling experiments in which neurites were labelled with tau or MAP2 antibodies, there were occasional cases where neurites came into direct contact with punctate laminin. These observations suggest a role for laminin in hippocampal development and possibly in neurite outgrowth.