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Closure of the Epiploic Foramen in the Horse: an Anatomical and Clinical Study.” 3URPRWRU3URI'U$0DUWHQVDQG'UV3:LHPHU

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Closure of the Epiploic Foramen in the Horse: an Anatomical and Clinical Study.”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p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†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ɣJOXWDP\OWUDQVIHUDVH K KRXU +( KDHPDWR[\OLQHRVLQ +5 KD]DUGUDWLR ,0 LQWUDPXVFXODU ,8 LQWHUQDWLRQDOXQLW ,9 LQWUDYHQRXV NJ NLORJUDP / OLWUH P PHWUH PJ PLFURJUDP PLQ PLQXWH P/ PLOOLOLWUH PP PLOOLPHWUH PP+J PLOOLPHWUHV0HUFXU\ 25 RGGVUDWLR 3&9 SDFNHGFHOOYROXPH 32, SRVWRSHUDWLYHLOHXV 32& SRVWRSHUDWLYHFROLF 325 SRVWRSHUDWLYHUHIOX[ 55 UHVSLUDWRU\UDWH VG VWDQGDUGGHYLDWLRQ 6$$ VHUXPDP\ORLG$ :%& ZKLWHEORRGFHOOV &+$37(5 *HQHUDOLQWURGXFWLRQDQGEDFNJURXQGRIWKHWKHVLV ϭ *HQHUDOLQWURGXFWLRQ “Winslow Foramen”, “Omental Foramen” or “Epiploic Foramen”? ,QWKH,OOXVWUDWHG9HWHULQDU\$QDWRPLFDO1RPHQFODWXUHHGLWHGE\&RQVWDQWLQHVFXDQG Schaller, which is widely considered “the bible of anatomical definitions” in the YHWHULQDU\DQDWRPLFDOFRPPXQLW\Whe “omental foramen” [epiploic foramen] is defined DV“the opening from the greater peritoneal sac to the omental vestibule that passes EHWZHHQ WKH FDXGDO YHQD FDYD GRUVDOO\ WKH SRUWDO YHLQ WKDW LV LQFOXGHG LQ WKH KHSDWRGXRGHQDO OLJDPHQW YHQWUDOO\ WKH FDXGDO OREH RI WKH OLYHU FUDQLDOO\ DQG WKH pancreas caudally” &RQVWDQWLQHVFXDQG6FKDOOHU 7KLVVOLWlike opening is called the “Winslow foramen” in human literaWXUHQDPHGDIWHU WKH)UHQFK'DQLVKGRFWRUDQGDQDWRPLVW-DFREDOLDV-DFTXHV%pQLJQH:LQVORZ ZKRILUVWGHVFULEHGWKLVHQLJPDWLFVWUXFWXUH %HOODU\HWDO +HZDVERUQ LQ'HQPDUNDQGZDVYHU\GHGLFDWHGWRWKH/XWKHUDQIDLWKDVZDVWKHIDPLO\WUDGLWLRQ 'XULQJKLVWKHRORJ\VWXGLHVKHPHWDPHGLFDOVWXGHQWZLWKZKRPKHIUHTXHQWO\KDG ORQJVSLULWXDOFRQYHUVDWLRQV. Winslow’s interest for medicDOVWXGLHVHPHUJHGIURPWKHVH FRQYHUVDWLRQVDQGKHGHFLGHGWRVWXG\PHGLFLQHZKHUHDVKLVIULHQGZDVFRQYHUWHGWR WKHRORJ\VWXGLHV7KHQDPHRIKLVIULHQGUHPDLQVXQNQRZQLQKLVWRU\EXWWKHPHGLFDO ZRUOGRZHVRQHRIWKHPRVWIDPRXVDQDWRPLVWVWRKLP 2UO\%HOODU\HWDO Winslow’s ambitions brought him to Holland and later on to Paris. As a member of the /XWKHULDQFRPPXQLW\KHZDVILQDQFLDOO\VXSSRUWHGIRUKLVVWXGLHVQRWRQO\E\KLVIDPLO\ EXWDOVRE\WKH'DQLVK&URZQ+RZHYHULQ3DULVKHUHQRXQFHGKLV/XWKHUDQIDLWKIRU &DWKROLFLVPXQGHULQIOXHQFHRIWKHIDPRXVELVKRSRI0HDX[-DTXHV%pQLJQH%RVVXHW ZKRVHQDPHKHDGRSWHGIURPWKDWPRPHQWRQ'XHWRWKLVFRQYHUVLRQ KHORVWKLVVFKRODUVKLSDQGKLVIDPLO\GLVRZQHGKLP+RZHYHUIURPWKDWPRPHQWRQ KHUHFHLYHGFRQWULEXWLRQVWRVXSSRUWKLVVWXG\DQGZRUNIURP&DWKROLFSDWURQVLQ3DULV ZKLFK DOORZHG KLP WR EXLOG D YHU\ SUROLILF FDUHHU ZLWK QXPHURXV SURIHVVLRQDO DFKLHYHPHQWV %HOODU\HWDO +HUHFHLYHGKLV0'GHJUHHLQZDVDGPLWWHG in the “Académie des Sciences” LQDQG\HDUVODWHUKHVXFFHHGHG)UDQoRLV Joseph Hunault to the chair of anatomy of the “Jardin du Roy”, which he held until 1758 2UO\ ϯ &KDSWHU )LJXUH 6WLSSOH HQJUDYLQJ RI -DFTXHV%pQLJQH :LQVORZ &ROOHFWLRQ RI WKH ©%LEOLRWKqTXH LQWHUXQLYHUVLWDLUHGHVDQWp3DULVª ,Q:LQVORZGHVFULEHGWKHDSHUWXUH IRUDPHQ ZKLFKFRQQHFWVWKHJUHDWHUDQG OHVVHUVDFVRIWKHSHULWRQHDOFDYLW\DQGQRZEHDUVKLVQDPH+HSXEOLVKHGWKHILUVW HGLWLRQRIKLVVHPLQDOZRUN“Exposition Anatomique de la Structure du Corps Humain” LQ +LV ZRUN ZDV UHFRJQL]HG DV WKH ILUVW DQDWRPLFDO WUHDWLVH RI GHVFULSWLYH DQDWRP\ ZLWKRXW DGGLWLRQ RI SK\VLRORJLFDO GHWDLOV DQG K\SRWKHWLFDO H[SODQDWLRQV EH\RQGWKHVFRSHRIDQDQDWRP\WH[W %HOODU\HWDO 7KLVPDQXDOVWDUWHGDQHZ JHQHUDWLRQRIDQDWRPLFDOKDQGERRNVLQIOXHQFLQJPDQ\DQDWRPLVWVDOODURXQG(XURSH 2UO\ ,WDOVRLQFOXGHGDGHVFULSWLRQRIWKHV\PSDWKHWLFQHUYRXVV\VWHPZKLFK ϰ *HQHUDOLQWURGXFWLRQ KDGDVLJQLILFDQWLQIOXHQFHRQWKHXQGHUVWDQGLQJRIWKLVFRQWURYHUVLDOSDUWRIWKHQHUYRXV V\VWHP 2UO\ The term “Winslow foramen” is QRW FRPPRQO\ XVHGLQ YHWHULQDU\ PHGLFLQH GHVSLWH -DFTXHVBénigne Winslow’s enormous contribution to medical development. The term “epiploic foramen” is still accepted as an official alternativeLQWKHUHYLVHGYHUVLRQRIWKH WK HGLWLRQ RI WKH 1RPLQD $QDWLPLFD 9HWHULQDULD1$9 >PHQWLRQHG EHWZHHQ VTXDUH brackets] although “omental foramen” is preferred :RUOG $VVRFLDWLRQRI 9HWHULQDU\ $QDWRPLVWV . In fact “pSLSORRQ” is a synonym for “RPHQWXP”, and iVXVHGEDVLFDOO\ LQ/DWLQODQJXDJHVDVIRUH[DPSOH)UHQFKRU6SDQLVK Equine clinicians continue to use the term “epiploic foramen” despite the preference for “omental foramen” in the vetHULQDU\DQDWRPLFDOFRPPXQLW\,WZDVGHFLGHGWRXVH “epiploic foramen” throughout WKLVWH[WDVWKHZRUNZDVPDLQO\FRQGXFWHGLQOLJKWRI FOLQLFDODSSOLFDWLRQVDQGLQWHUQDWLRQDOYHWHULQDU\FOLQLFDOMRXUQDOVDQGOLWHUDWXUHGRQRW accept “omental foramen” yet as the new terminologyinstead of “epiploic foramen”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ϱ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ϲ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ϳ &KDSWHU $QDWRP\RIWKHHSLSORLFIRUDPHQLQWKHKRUVH 7KHYHWHULQDU\LQWHUVSHFLHVGHILQLWLRQRIWKHHSLSORLFIRUDPHQLV“the
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