Shock-Associated Nonocclusive Ischemic Colitis in an Infant: A Very Rare Complication of Incarcerated Inguinal Hernia

Abstract

Ischemic colitis is a common disorder in the elderly, with 60% of those affected being older than 70 years of age (1). Shock-associated nonocclusive ischemic colitis has been documented in case reports in young persons (2). A case of ischemic colitis in a 3-month-old boy as a complication of right incarcerated inguinal hernia is presented. Sigmoidoscopy showed extensive mucosal ulceration with pseudomembrane formation in the left colon sparing the rectum and a localized necrosis in the sigmoid colon. Differential diagnosis of ischemic colitis from pseudomembranous colitis was made on the basis of the lack of response to oral vancomycin, the negative stool cytotoxin assay for Clostridium difficile and the serositis at the surgical finding. To the best of our knowledge, this is the first report of ischemic colitis in infancy and of ischemic colitis by incarcerated inguinal hernia.