The epiploic foramen (foramen of Winslow) is the communication between the lesser sac (omental bursa) and the greater peritoneal cavity, bounded anteriorly by the hepatoduodenal ligament (containing the portal triad), posteriorly by the IVC, superiorly by the caudate lobe, and inferiorly by the first part of the duodenum.
The epiploic foramen is the route of internal herniation when bowel loops pass through into the lesser sac, producing acute intestinal obstruction requiring emergency reduction. It is a key landmark in hepatobiliary surgery where the Pringle manoeuvre (digital compression of the hepatoduodenal ligament) controls hepatic inflow by occluding the foramen. Cholecystectomy approaches routinely identify the foramen boundaries before clip application.
Internal herniation of small bowel through the epiploic foramen into the lesser sac producing acute intestinal obstruction, requiring emergency laparotomy for reduction to avoid bowel ischaemia.
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