Perforation causing abdominal compartment syndrome after colonoscopic polypectomy: A case report

https://doi.org/10.1016/j.ijscr.2019.06.050Get rights and content
Under a Creative Commons license
open access

Highlights

  • Colonoscopic perforation with Abdominal compartment syndrome (ACS) is a rare complication that should be kept in mind.

  • ACS deteriorates hemodynamic status and respiratory system rapidly, and may be fatal if left untreated.

  • Decompression for ACS including paracentesis and surgical intervention.

Abstract

Introduction

Bowel perforation is a potential complication of colonoscopy, and colonoscopic polypectomy has a higher risk. Perforation may be responsible for abdominal compartment syndrome (ACS), which causes multiple organ dysfunction.

Case presentation: Here, we have described the case of a woman who underwent colonoscopic polypectomy. Subsequent to the procedure, she developed progressive abdominal distension, dyspnea, drowsy consciousness, and hypotension. Her physical examination revealed increased abdominal circumference, coldness, and paleness of the lower limbs. ACS were accordingly diagnosed, most likely to have resulted from bowel perforation. Thus, decompression with a large-bore intravenous catheter and emergent laparotomy were performed. A 0.5-cm lesion over the cecum was discovered and repaired. The patient tolerated the procedure well and underwent intensive care. She was discharged on day 7 after operation, and she had completely recovered.

Discussion

ACS is a rare complication followed by perforation after colonoscopy. Multiple organ dysfunction may occur from ACS, affecting the cardiovascular, pulmonary, and gastro-intestinal system. In our case, we used a small-sized catheter for decompression but in vain due to the kinking of the catheter. ACS was eventually resolved via surgical intervention. Thus, when ACS occurred, emergent decompression with an appropriate size of catheter and surgical intervention are recommended.

Conclusion

Colonoscopy perforation must be considered as a contributing factor to ACS; accordingly, early recognition and intervention may avoid deterioration of ACS.

Keywords

Colonoscopy
Intra-abdominal hypertension
Abdominal compartment syndrome
Polypectomy
Case report

Cited by (0)