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Open Access Case report

Perforated sigmoid diverticulitis in a lumbar hernia after iliac crest bone graft - a case report

Florian S Frueh12, Raphael N Vuille-dit-Bille13, Dimitri A Raptis4, Hanspeter Notter1* and Brigitte S Muff1

Author Affiliations

1 Department of Surgery, Hospital of Bulach, Spitalstrasse 24, 8180 Bulach, Switzerland

2 Division of Plastic Surgery and Hand Surgery, University Hospital of Zurich, Zurich, Switzerland

3 Department of Pediatric Surgery, University Children’s Hospital of Zurich, Zurich, Switzerland

4 Department of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland

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BMC Surgery 2014, 14:46  doi:10.1186/1471-2482-14-46

Published: 22 July 2014

Abstract

Background

The combination of perforated diverticulitis in a lumbar hernia constitutes an extremely rare condition.

Case presentation

We report a case of a 66 year old Caucasian woman presenting with perforated sigmoid diverticulitis localized in a lumbar hernia following iliac crest bone graft performed 18 years ago. Emergency treatment consisted of laparoscopic peritoneal lavage. Elective sigmoid resection was scheduled four months later. At the same time a laparoscopic hernia repair with a biologic mesh graft was performed.

Conclusion

This case shows a very seldom clinical presentation of lumbar hernia. Secondary colonic resection and concurrent hernia repair with a biologic implant have proven useful in treating this rare condition.

Keywords:
Perforated diverticulitis; Lumbar hernia; Iliac crest bone graft; Laparoscopic hernia repair; Mesh