Endoscopic Treatment of Iatrogenic Perforation of Sigmoid Diverticulum: A Case Report of Multidisciplinary Management
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Iatrogenic perforations are severe complications of gastrointestinal endoscopy; therefore, their management should be adequatelyplanned. A 77-year-old man with a history of diverticulosis underwent a colonoscopy for anemia. During the procedure, aniatrogenic perforation occurred suddenly in the sigmoid colon, near a severe angle among the numerous diverticula. Through-thescopeclips were immediately applied to treat it and close mucosal edges. Laboratory tests showed increased levels of inflammationand infection, and although there were no complaints of abdominal pain, the patient had an extremely distended abdomen. Amultidisciplinary board began management based on a conservative approach. Pneumoperitoneum was treated with computedtomography-assisted drainage. After 72 hours, his intestinal canalization and laboratory tests were normal. Though this adverseevent is rare, a multidisciplinary board should be promptly gathered upon occurrence, even if the patient appears clinically stable, toconsider a conservative approach and avoid surgical treatment.
Abstract
Iatrogenic perforations are severe complications of gastrointestinal endoscopy; therefore, their management should be adequatelyplanned. A 77-year-old man with a history of diverticulosis underwent a colonoscopy for anemia. During the procedure, aniatrogenic perforation occurred suddenly in the sigmoid colon, near a severe angle among the numerous diverticula. Through-thescopeclips were immediately applied to treat it and close mucosal edges. Laboratory tests showed increased levels of inflammationand infection, and although there were no complaints of abdominal pain, the patient had an extremely distended abdomen. Amultidisciplinary board began management based on a conservative approach. Pneumoperitoneum was treated with computedtomography-assisted drainage. After 72 hours, his intestinal canalization and laboratory tests were normal. Though this adverseevent is rare, a multidisciplinary board should be promptly gathered upon occurrence, even if the patient appears clinically stable, toconsider a conservative approach and avoid surgical treatment.
참고문헌 (20)
- Raju GS, "Endoscopic management of colonoscopic perforations(with videos)", Gastrointest Endosc, 74, pp.1380~1388 (2011)
- Paspatis GA, "Diagnosis and management of iatrogenic endoscopic perforations : European Society of Gastrointestinal Endoscopy(ESGE)Position Statement-Update 2020", Endoscopy, 52, pp.792~810 (2020)
- Toyonaga T, "1, 635 Endoscopic submucosal dissection cases in the esophagus, stomach, and colorectum : complication rates and long-term outcomes", Surg Endosc, 27, pp.1000~1008 (2013)
- Paspatis GA, "Sixty-versus thirty-seconds papillary balloon dilation after sphincterotomy for the treatment of large bile duct stones : a randomized controlled trial", Dig Liver Dis, 45, pp.301~304 (2013)
- Mangiavillano B, "Over-the-scope clips in the treatment of gastrointestinal tract iatrogenic perforation : A multicenter retrospective study and a classification of gastrointestinal tract perforations", World J Gastrointest Surg, 8, pp.315~320 (2016)
- Jayanna M, "Cost analysis of endoscopic mucosal resection vs surgery for large laterally spreading colorectal lesions", Clin Gastroenterol Hepatol, 14, pp.271~278 (2016)
- Martínez-Pérez A, "Laparoscopic vs. open surgery for the treatment of iatrogenic colonoscopic perforations : a systematic review and meta-analysis", World J Emerg Surg, 12, pp.8~ (2017)
- Tursi A, "Development and validation of an endoscopic classification of diverticular disease of the colon : the DICA classification", Dig Dis, 33, pp.68~76 (2015)
- de’Angelis N, "2017 WSES guidelines for the management of iatrogenic colonoscopy perforation", World J Emerg Surg, 13, pp.5~ (2018)
- An SB, "Decision-making in the management of colonoscopic perforation : a multicentre retrospective study", Surg Endosc, 30, pp.2914~2921 (2016)
- Derbyshire E, "Colonoscopic perforations in the English National Health Service Bowel Cancer Screening Programme", Endoscopy, 50, pp.861~870 (2018)
- Mai CM, "Iatrogenic colonic perforation by colonoscopy : a fatal complication for patients with a high anesthetic risk", Int J Colorectal Dis, 25, pp.449~454 (2010)
- Carpio G, "Management of colonic perforation after colonoscopy. Report of three cases", Dis Colon Rectum, 32, pp.624~626 (1989)
- Lim DR, "The analysis of outcomes of surgical management for colonoscopic perforations : a 16-years experiences at a single institution", Asian J Surg, 43, pp.577~584 (2020)
- Raju GS, "Endoscopic clip closure of gastrointestinal perforations, fistulae, and leaks", Dig Endosc, 26(Suppl 1), pp.95~104 (2014)
- 정윤호, "Endoscopic Management of Iatrogenic Colon Perforation", Clinical Endoscopy, 53(1), pp.29~36 (2020), 대한소화기내시경학회[DOI]
- Cho SB, "Therapeutic options for iatrogenic colon perforation : feasibility of endoscopic clip closure and predictors of the need for early surgery", Surg Endosc, 26, pp.473~479 (2012)
- Saltzman HA, "Intestinal response to changing gaseous environments : normobaric and hyperbaric observations", Ann NY Acad Sci, 150, pp.31~39 (1968)
- ASGE Technology Committee, "The use of carbon dioxide in gastrointestinal endoscopy", Gastrointest Endosc, 83, pp.857~865 (2016)
- Memon MA, "Carbon dioxide versus air insufflation for elective colonoscopy : a meta-analysis and systematic review of randomized controlled trials", Surg Laparosc Endosc Percutan Tech, 26, pp.102~116 (2016)