Epiploic Foramen

foramen epiploicum (Winslowi)

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.

Anatomical Data

Boundaries & Contents

Location	Upper abdomen, a short opening behind the free edge of the lesser omentum
Boundaries	Free edge of the hepatoduodenal ligament with the portal vein, hepatic artery proper and bile duct (front) Inferior vena cava and right crus of the diaphragm (back) Caudate process of the liver (above) First part of the duodenum (below)

Biomechanics

Function & Actions

The only natural opening between the greater and lesser sacs. Squeezing the ligament in front of it (Pringle manoeuvre) controls blood flow into the liver, and bowel can rarely herniate through it.

Clinical Relevance

Clinical Notes

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.

Pathology

Common Injuries & Conditions

Foramen of Winslow Hernia

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.

Explore

More in Abdomen

Browse all of Abdomen →