Abstract
A 72-year-old man developed a bulge from the right inguinal region to the scrotum during colonoscopy. The scrotum had swollen to 20 cm in size. From abdominal CT findings, right inguinal hernia in which the greater omentum and the colon had been incarcerated was diagnosed. Since the hernia could not be reduced by manipulation, an emergency operation under general anesthesia was performed. The patient was as extremely obese as the BMI of 35 and his incarcerated hernia was so huge that demanded us to approach to the hernia from a midline laparotomy at the lower abdomen and from the inguinal region. The hernia contained the greater part of the omentum and the transverse colon. The omentum was partially excised ; the contents in the colon were absorbed from a small opening at the injured transverse colon to decompress the pressure within the colon ; and the herniated organs were able to be returned in the abdomen. After closure of the small opening, the inguinal hernia was repaired by the iliopubic tract repair method. He developed respiratory failure after the operation, but it was ameliorated in a short time.
Incarcerated hernia as a complication of colonoscopy has rarely been reported so far, and clinical cases of inguinal hernia in which the transverse colon is incarcerated are extremely rare. Accordingly our case is presented here, together with a review of the literature.
