Virtual colonoscopy image of sigmoid colon in an incisional hernia.
A 57-year-old man complaining of 3 months of new constipation presented for an average risk screening colonoscopy. The examination was terminated because of an inability to pass the colonoscope beyond an acute angulation in the left colon. CT colonography was obtained the same day in order to complete the examination.
The CT demonstrated the presence of a loop of sigmoid colon herniating through the anterior abdominal wall, and causing significant obstruction to the retrograde flow of gas, even precluding an adequate CT examination of the proximal colon. The herniation was located at the incisional site of a penile prosthesis implantation surgery performed 5 months ago.
The clinical impression was that the constipation was a result of this colonic herniation. The patient was referred to a surgeon for herniorraphy.
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