Perforated diverticulum of descending colon imitating incarcerated left inguinal hernia: a clinical case report and review of the literature

Bulgarian Medical Journal, 2024, 18(4), 55-57.

N. Mena

Clinic of Surgery, Hospital of Wallis, Hospital Centre of Oberwallis – Visp, Switzerland

Abstract. A clinical case of an 85-year-old male with a rare perforated diverticulum on the posterior wall of descending colon imitating incarcerated left inguinal hernia with colonic contents is reported. Laparoscopically, the echographic diagnosis of hernia was not confirmed. During the median laparotomy, numerous diverticula of the descending colon and a closed perforated diverticulum with left retroperitoneal abscess along the whole inguinal canal to its external orifice were revealed. After the resection of the colonic area with the diverticulum, left hemicolectomy with transversal rectostomy and retroperitoneal mobilization of the left lateral canal between the lienal flexure and the left inguinal canal were accomplished. In the review of the literature, several other clinical cases is described, and the selection of the operative techniques for reconstruction is discussed. Timely recognition of atypical clinical forms of the perforated colonic diverticulosis considerably improves the individualized surgical practice and patient’s prognosis.

Key words: inguinal hernia, perforated colonic diverticulum, surgery, clinical case

Address for correspondence: Natmir Mena, MD, PhD, Clinic of Surgery, Hospital of Wallis, Hospital Centre of Oberwallis 3930 Visp, Switzerland, e-mail: natmirmena1@gmail.com