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Yao WX, Li YH, Deng B, Wu LG, Du L. Colonoscope incarceration in an inguinal hernia complicated by ischemic bowel disease: A case report. World J Gastrointest Surg 2026; 18(11): 124759 [DOI: 10.4240/wjgs.124759]
World J Gastrointest Surg. Nov 27, 2026; 18(11): 124759 Published online Nov 27, 2026. doi: 10.4240/wjgs.124759
Colonoscope incarceration in an inguinal hernia complicated by ischemic bowel disease: A case report
Wu-Xiu Yao, Ya-Hui Li, Bo Deng, Li-Guo Wu, Ling Du
Wu-Xiu Yao, Ya-Hui Li, Bo Deng, Li-Guo Wu, Ling Du, Department of Gastroenterology and Endoscopy, Chengdu Wenjiang District People’s Hospital, Chengdu 610003, Sichuan Province, China
Author contributions: Yao WX contributed to writing - original draft; Li YH contributed to data curation; Deng B contributed to investigation; Wu LG contributed to project administration; Du L contributed to writing - review & editing.
AI contribution statement: AI tools were not listed as authors and were not used to generate original research data, conduct independent analyses, interpret results autonomously, or draw scientific conclusions. All scientific reasoning, methodological decisions, data interpretation, and conclusions were developed and validated exclusively by the authors.
Informed consent statement: Informed patient consent for publication of this case report has been obtained in written form.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Ling Du, MD, Department of Gastroenterology and Endoscopy, Chengdu Wenjiang District People’s Hospital, No. 86 Taikang Road, Wenjiang District, Chengdu 610000, Sichuan Province, China. 304263173@qq.com
Received: June 30, 2026 Revised: July 29, 2026 Accepted: August 25, 2026 Published online: November 27, 2026 Processing time: 135 Days and 16.6 Hours
Abstract
BACKGROUND
Colonoscopy is widely used for the diagnosis and treatment of colorectal diseases, with bleeding and perforation being the most recognized complications. Colonoscope incarceration within an inguinal hernia is an exceptionally rare mechanical complication, and secondary ischemic bowel injury has not been previously reported.
CASE SUMMARY
A 67-year-old man undergoing colonoscopy developed sudden complete fixation of the colonoscope at approximately 40 cm from the anal verge. Physical examination revealed a palpable mass in the left inguinal region. Pelvic X-ray demonstrated incarceration of the colonoscope in a characteristic reversed “S” configuration. Two-person manual reduction successfully released the scope. Subsequent colonoscopy showed continuous congestion, edema, and superficial necrosis of the sigmoid colon mucosa with clear demarcation from adjacent normal tissue. Histopathological examination confirmed ischemic mucosal injury. Computed tomography demonstrated a left inguinal hernia. The patient subsequently underwent elective hernia repair and recovered without further gastrointestinal complications. This case represents the first reported instance of ischemic bowel injury secondary to colonoscope incarceration within an inguinal hernia. Early recognition, prompt groin examination, imaging confirmation, coordinated manual reduction, and post-reduction mucosal assessment are essential for optimal management.
CONCLUSION
Routine pre-colonoscopy screening for inguinal hernia should be considered to prevent this rare but potentially severe complication.
Core Tip: Colonoscope incarceration in an inguinal hernia is an exceedingly rare mechanical complication, and its association with secondary ischemic bowel injury has never been reported. We present a 67-year-old male in whom the colonoscope became completely fixed during routine colonoscopy, with pelvic X-ray revealing a classic reversed “S” configuration within a left inguinal hernia. Two-person manual reduction successfully released the scope, but subsequent endoscopic and histopathological examination confirmed ischemic mucosal necrosis. This case is the first to document ischemic bowel injury following hernia-related scope incarceration. Early recognition, prompt groin examination, imaging confirmation, and post-reduction mucosal assessment are critical. Routine pre-colonoscopy hernia screening warrants consideration.
