Occult Spigelian Hernia Presenting as Inability to Complete Colon Cancer Screening in a Patient with a History of Rectal Cancer

An Unusual Presentation of Spigelian Hernia Incarceration after Colonoscopy

Spigelian hernias are uncommon and predominantly affect the abdominal wall.The incidence of Spigelian hernias after colonoscopy is even rarer with only one case outlined in the surgical literature. This is the case of a 66-year-old man who underwent routine colonoscopy and presented to the hospital with systemic inflammatory response syndrome (SIRS). A computed tomography (CT) scan demonstrated a Spigelian hernia in the location of a prior left ventricular assist device (LVAD) placement. This required surgical resection and resulted in a complicated post-operative course. This case offers a unique perspective on a rare colonoscopic complication not well represented in the literature. It offers the learning point of remaining vigilant for a rare, but potentially deadly, colonoscopic outcome. This case also illustrates the decision-making heuristic of availability bias.