A 41-year-old woman, who presented with acute onset of generalized per
itonitis, was found to have a segment of strangulated small bowel inca
rcerated in the lesser peritoneal sac through the foramen of Winslow.
The strangulated small bowel was reduced and resected. The predisposin
g factors for this condition as mentioned in the literature were not p
resent in this case. In particular, the herniation was associated with
a small foramen of Winslow and the presentation was one of rapidly de
veloping peritonitis.