Complicated Inguinal Hernia Incidentally Detected on a Radiolabelled Autologous White Blood Cell Scan

A 73-year-old male with left hip prosthesis infection performed a 99mTc HMPAO–labelled autologous WBC (WBC) scan to evaluate the response to antibiotic therapy. Since the early planar scan, an area of increased activity was visible extending from the left groin region to the ipsilateral flank. At late planar images, the area progressively focused in the left groin, site of a painful inguinal hernia. The contextual tomographic acquisition showed increased activity partly referable to non- specific intestinal contents and partly localized at the parietal wall of the herniated intestinal loop. Our case suggests that the incidental detection of increased accumulation of WBC in correspondence of the intestinal wall of an inguinal hernia may indicate inflammatory involvement and subsequent further complications.