When perforation is not the culprit : case report and systematic review of mechanical small-bowel obstruction complicating colonoscopy
Journal | Volume 81 - 2018 |
Issue | Fasc.1 - Case reports |
Author(s) | V. Papastergiou, N. Mathou, K. Manes, P. Maniatis, K. Paraskeva, A. Evgenidi, A. Giannakopoulos, J. A. Karagiannis |
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(1) Gastroenterology Department, “Konstantopoulio” General Hospital, Athens, Greece ; (2) Surgical Department, “Konstantopoulio” General Hospital, Athens, Greece ; (3) Radiology Department, “Konstantopoulio” General Hospital, Athens, Greece. |
Colonoscopy is generally safe, although expansion of colorectal cancer prevention programs is likely to increase the number of post-colonoscopy complications. We report the case of a 42-year- old woman with a prior history of 2 cesarean section deliveries who developed abdominal pain after an otherwise uneventful screening colonoscopy. Urgent exploration revealed closed-loop obstruction involving the terminal ileum, caused by an adhesive band close to the site of her previous Pfannenstiel incision. A systematic review of the literature revealed 11 reports (1985-2008) describing a total of 13 cases of mechanical small bowel obstruction (MSBO) after colonoscopy, 9 of which were confirmed by laparo- tomy. Colonoscopy-induced MSBO is practically impossible to anticipate, and only a prior history of abdominal/pelvic surgery may be deemed as a predisposing factor. However, it is related to significant morbidity, as it often leads to an ischemic bowel with need for surgical resection. Thus, endoscopists should be aware and maintain a low operative threshold to this rare, but hazardous, complication of colonoscopy. (Acta gastroenterol. belg., 2018, 81, 89-92). |
© Acta Gastro-Enterologica Belgica. PMID 29562381 |