Limits...
Perforation of a Long-standing Ileocolonic Anastomosis During Colonoscopy.

Tofani CJ, Phillips B, McCue P, Baliff J, Kastenberg D - ACG Case Rep J (2015)

Bottom Line: Colonoscopy is a valuable diagnostic and therapeutic procedure.We present a 69-year-old woman who, during colonoscopy, had a perforation secondary to barotrauma of a long-standing ileocolonic anastomosis proximal to the point of colonoscopic intubation.To our knowledge, this is the first case report of a perforation of a well-established anastomosis proximal to the point of endoscope intubation during colonoscopy.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, PA.

ABSTRACT
Colonoscopy is a valuable diagnostic and therapeutic procedure. Colonic perforation is a serious complication of colonoscopy that must be promptly recognized to limit morbidity and mortality. We present a 69-year-old woman who, during colonoscopy, had a perforation secondary to barotrauma of a long-standing ileocolonic anastomosis proximal to the point of colonoscopic intubation. To our knowledge, this is the first case report of a perforation of a well-established anastomosis proximal to the point of endoscope intubation during colonoscopy.

No MeSH data available.


Related in: MedlinePlus

An established defect centered in the lamina propria and extending into the muscularis propria. There is associated mixed inflammation and early organization around its periphery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4508947&req=5

Figure 2: An established defect centered in the lamina propria and extending into the muscularis propria. There is associated mixed inflammation and early organization around its periphery.

Mentions: Immediately post-procedure, the patient experienced severe abdominal pain and distension. Abdominal x-ray showed pneumoperitoneum and emergent laparotomy was performed (Figure 1). A pinhole perforation was identified at the “crotch” of the stapled ileocolonic anastomosis with a large amount of pneumoperitoneum. There was no feculent material within the abdomen, and the ileum and colon appeared normal. The ileocolonic anastomosis was resected and a sewn side-to-end terminal ileum to mid-transverse colon anastomosis performed. Pathological evaluation of the resected ileocolonic anastomosis showed a focus of submucosal myxoid degeneration with organizing fibrosis and rare multinucleated giant cells in the colon; the overlying colonic mucosa was normal (Figures 2 and 3). No granulomas or infectious organisms were identified. The postoperative course was complicated by atelectasis and obesity hypoventilation syndrome. She was gradually weaned from supplemental oxygen and discharged on 6 days later.


Perforation of a Long-standing Ileocolonic Anastomosis During Colonoscopy.

Tofani CJ, Phillips B, McCue P, Baliff J, Kastenberg D - ACG Case Rep J (2015)

An established defect centered in the lamina propria and extending into the muscularis propria. There is associated mixed inflammation and early organization around its periphery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508947&req=5

Figure 2: An established defect centered in the lamina propria and extending into the muscularis propria. There is associated mixed inflammation and early organization around its periphery.
Mentions: Immediately post-procedure, the patient experienced severe abdominal pain and distension. Abdominal x-ray showed pneumoperitoneum and emergent laparotomy was performed (Figure 1). A pinhole perforation was identified at the “crotch” of the stapled ileocolonic anastomosis with a large amount of pneumoperitoneum. There was no feculent material within the abdomen, and the ileum and colon appeared normal. The ileocolonic anastomosis was resected and a sewn side-to-end terminal ileum to mid-transverse colon anastomosis performed. Pathological evaluation of the resected ileocolonic anastomosis showed a focus of submucosal myxoid degeneration with organizing fibrosis and rare multinucleated giant cells in the colon; the overlying colonic mucosa was normal (Figures 2 and 3). No granulomas or infectious organisms were identified. The postoperative course was complicated by atelectasis and obesity hypoventilation syndrome. She was gradually weaned from supplemental oxygen and discharged on 6 days later.

Bottom Line: Colonoscopy is a valuable diagnostic and therapeutic procedure.We present a 69-year-old woman who, during colonoscopy, had a perforation secondary to barotrauma of a long-standing ileocolonic anastomosis proximal to the point of colonoscopic intubation.To our knowledge, this is the first case report of a perforation of a well-established anastomosis proximal to the point of endoscope intubation during colonoscopy.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, PA.

ABSTRACT
Colonoscopy is a valuable diagnostic and therapeutic procedure. Colonic perforation is a serious complication of colonoscopy that must be promptly recognized to limit morbidity and mortality. We present a 69-year-old woman who, during colonoscopy, had a perforation secondary to barotrauma of a long-standing ileocolonic anastomosis proximal to the point of colonoscopic intubation. To our knowledge, this is the first case report of a perforation of a well-established anastomosis proximal to the point of endoscope intubation during colonoscopy.

No MeSH data available.


Related in: MedlinePlus