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We report a case of ileal internal hernia through the foramen of Winslow into the lesser sac. Preoperative computed tomography (CT) demonstrated that the herniated ileum, which showed a closed-loop obstruction, was located behind the portal vein, and the vein was subsequently compressed and narrowed by the herniated ileum. We found that similar cases in the literature of Winslow's foramen hernias that caused portal vein compression; however, portal vein narrowing has not been described as a characteristic CT finding. The narrowed portal vein sign could be useful in diagnosing the hernia through the foramen of Winslow.

小腸過誤腫はPeutz-Jeghers症候群において認めることが多いが,稀に非遺伝性で,色素斑の合併を欠く症例もみられる.今回われわれは小腸過誤腫による成人腸重積症の1例を経験したので報告する.症例は26歳の女性で,右下腹部痛を主訴として来院した.超音波,腹部CT検査にて腸重積症と診断され,緊急手術を施行した.拇指頭大の腫瘤を先進部とした回腸が上行結腸に嵌入していた.回盲部切除術を施行した.回腸の腫瘤は病理組織学的検索により過誤腫性ポリープと診断された.小腸過誤腫は画像診断で確定診断に至ることは困難で,腸重積やイレウスなどの腸閉塞症状や下血などの合併症がみられることで外科的切除となることが多い.