Case Report
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World J Gastrointest Endosc. Oct 16, 2014; 6(10): 510-512
Published online Oct 16, 2014. doi: 10.4253/wjge.v6.i10.510
Novel use of cap-assisted enteroscopy for detection of colorectal tumor in a patient with incarcerated inguinal hernia
Victoria PY Tan, Ivan WC Wong, Yuk Tong Lee
Victoria PY Tan, Department of Medicine, University of Hong Kong, Hong Kong, China
Ivan WC Wong, Faculty of Medicine, University of Hong Kong, Hong Kong, China
Yuk Tong Lee, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
Author contributions: Tan VPY and Wong IWC wrote the manuscript and performed the literature search; Tan VPY and Lee YT reviewed and selected the images for publication; Lee YT performed the procedure and acquired the images for publication; Tan VPY, Lee YT and Wong IWC approved the final version for publication.
Correspondence to: Dr. Victoria PY Tan, Department of Medicine, University of Hong Kong, Room 803, Administrative Building, Hong Kong, China.vpytan@hku.hk
Telephone: +852-22554049 Fax: +852-28186474
Received: March 5, 2014
Revised: April 30, 2014
Accepted: September 16, 2014
Published online: October 16, 2014
Processing time: 226 Days and 20.1 Hours
Abstract

Multiple reports have documented unsuspected inguinal hernias which result in difficulties during the colonoscopic examinations of patients. In most cases, the colonoscopy can be delayed until a surgical consult has further evaluated the inguinal hernia. This case report documents a patient who required a colonoscopy but surgical intervention for the detected inguinal hernia was not appropriate due to his co-morbid medical conditions. With the use of the combination of an enteroscope fitted with a cap and fluoroscopy, the inguinal hernia was able to be negotiated and the diagnosis of a cecal carcinoma was able to be confirmed.

Keywords: Inguinal hernia; Cap-assisted colonoscopy; Cecal carcinoma; Fluoroscopy; Enteroscope

Core tip: Patients with inguinal hernias who are unfit for surgical repair but who have otherwise strong indications for colonoscopy are at risk of failed colonoscopy or an incarcerated colonoscope. This case study demonstrates that the use of a cap fitted to a more flexible enteroscope with fluoroscopic guidance can aid in the negotiation of the scope past the loops of bowel in the hernia sac.