Gastrointestinal Perforation Induced by Incarcerated Lumbar Hernia through an Iliac Crest Bone Graft Site

Abstract

The patient was a 60-year-old woman, who, at the age of 59, underwent right elbow arthroplasty for rheumatoid arthritis using an autogenous graft from the right iliac crest. She was admitted to our emergency medicine department due to fever and disturbance of consciousness. Contrasted enhanced CT showed prolapse of the transverse colon at the right cranial iliac crest, ascites and free air. We diagnosed digestive tract perforation induced by incarcerated lumbar hernia. We performed right hemicolectomy to resect the perforated transverse colon, and lumbar hernia repair with suturation and omental patch. A tracheotomy was performed because of respiratory failure. Her respiratory condition and state of consciousness improved. She recovered with multidisciplinary treatment and was discharged 79 days after operation.