Abstract

An Unusual Presentation of Spigelian Hernia Incarceration After Colonoscopy

Highlights

  • Clinicians must be aware of potential rare complications after colonoscopy

  • There is only one case in the literature by Demuro which discusses a Spigelian hernia after colonoscopy, Persinger and Basson recently published a case report discussing the inability to conduct a colonoscopy due to the presence of a Spigelian hernia [3,4]

  • This is the first case to discuss a Spigelian hernia developing at the site of prior left ventricular assist device (LVAD) placement

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Summary

Introduction

Clinicians must be aware of potential rare complications after colonoscopy. This is relevant because every patient is advised to get a screening colonoscopy at age 50, making this an exceedingly common procedure. American College of Gastroenterology Annual Meeting; October 15, 2018) This case discussion of a 66-year-old man who underwent routine colonoscopy, returning with worsening abdominal pain and systemic inflammatory response syndrome (SIRS) is a common scenario. The diagnosis of microperforation after colonoscopic insufflation was considered, and computed tomography (CT) of the abdomen was obtained to assess for free air in the abdomen to suggest perforation This scan, seen, did not show any signs of perforation, but did show colonic extension from the hepatic flexure back inferolaterally into a Spigelian hernia with mild fat stranding. A repeat CT abdomen, shown, showed persistent colonic wall thickening over a 10 cm segment of transverse colon The white arrow shows the hernia which is reduced in relation to Figure 1

Discussion
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Disclosures
Demuro JP

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