Case Report
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World J Gastrointest Endosc. Jun 16, 2013; 5(6): 304-307
Published online Jun 16, 2013. doi: 10.4253/wjge.v5.i6.304
Incarceration of a colonoscope in an inguinal hernia: Case report and literature review
Victoria Ping-Yi Tan, Yuk Tong Lee, Jensen Tung Chung Poon
Victoria Ping-Yi Tan, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
Yuk Tong Lee, Jensen Tung Chung Poon, Department of Surgery, Queen Mary Hospital, Hong Kong, China
Author contributions: Tan VP performed the endoscopy, literature review and wrote the manuscript; Lee YT reviewed and edited the manuscript; Poon JTC performed the endoscopy and reviewed the manuscript.
Correspondence to: Dr. Victoria Ping-Yi Tan, MD, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong, China. vpytan@hku.hk
Telephone: +85-2-22554049 Fax: +85-2-28186474
Received: February 18, 2013
Revised: April 23, 2013
Accepted: April 28, 2013
Published online: June 16, 2013
Processing time: 111 Days and 9.1 Hours
Abstract

Incarceration of an endoscope in an inguinal hernia may occur during the course of routine colonoscopy. The incarceration may occur on insertion or withdrawal and frequently the hernia is not suspected prior to the colonoscopy. Most commonly, a left sided inguinal hernia is involved, however right inguinal hernias may be implicated in subjects with altered anatomy post abdominal surgery. Incarceration of an endoscope in an inguinal hernia has been seldom reported in the literature which is likely to be related to under reporting. A range of techniques have been suggested by various authors over the last four decades to manage this unusual complication of colonoscopy. These techniques include utilizing fluoroscopy, manual external pressure and/or the fitting of a cap onto the tip of the colonoscope to facilitate colonoscopic navigation. The authors present a case report of incarceration of the colonoscope on withdrawal in an unsuspected left inguinal hernia with a review of the literature on the management of this colonoscopic complication. A management strategy is suggested.

Keywords: Colonoscopy; Inguinal hernia; Fluoroscopy

Core tip: Incarceration of a colonoscope in an inguinal hernia is likely an under reported occurrence. The authors present a case report and literature review of incarceration of a colonoscope in an inguinal hernia and a suggested management algorithm.