Perforation during colonoscopy. A case report of an unusual complication.
Castellanos Villanueva DL, Adame Gutierrez AY, Avalos Bishop A, Arizmendi Villarreal MA. Perforation during colonoscopy. A case report of an unusual complication. Am J Med Surg. January 2022; 6(3). 6-10
BACKGROUND: Intestinal perforation is defined as the evidence of air, gastrointestinal content, or liquids outside the digestive tract, which may cause pneumoperitoneum, pneumomediastinum, pneumothorax, and cutaneous emphysema(1). Perforation rates are around 1% in frequency, morbidity goes up to 44% and mortality up to 25% during surgery (2). Risk factors are general health status, advanced age, and other comorbidities (3,4). When perforation occurs, the patient may present abdominal pain, a positive Blumberg's sign, and isolated tachycardia(5,6).
The diagnosis, in many cases, is not difficult, since abdominal radiography can detect the presence of air in the abdominal cavity(7), and laboratory studies reveal a raise in inflammatory markers(8).
The treatment can be conservative management with clinical and imaging monitoring, hydration and antibiotic therapy; or surgical management, which consists of closure or resection with primary anastomosis of the site of injury(2). We present a case of perforation in the transverse colon during a colonoscopy.
KEY WORDS: Colonoscopy, colonic perforation.