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Published on: July 11, 2025
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Intraperitoneal and extraperitoneal colonic perforation following diagnostic colonoscopy
Ahmed Dehal1, Deron J Tessier2
1Department of General Surgery, Kaiser Permanente, 9961 Sierra Ave, Fontana, CA 92335, USA. ahmed.dehal@gmail.com.
Summary
Colonoscopy can cause rare combined intraperitoneal and extraperitoneal colonic perforations. This case highlights the importance of early diagnosis and surgical intervention for a favorable outcome in such complex gastrointestinal emergencies.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Medical Imaging
Background:
- Colonoscopy is a valuable diagnostic and therapeutic tool.
- Colonic perforations, both intraperitoneal and extraperitoneal, are known complications of colonoscopy.
- Combined intraperitoneal and extraperitoneal colonic perforations are exceptionally rare.
Observation:
- A 55-year-old male with Crohn disease presented with acute abdominal pain post-colonoscopy.
- CT scan revealed extensive pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum, and left pneumothorax.
- Surgical exploration identified a combined intraperitoneal and extraperitoneal colonic perforation.
Findings:
- The patient underwent subtotal colectomy and end ileostomy.
- A left-sided chest drain was placed for pneumothorax.
- The patient recovered well postoperatively.
Implications:
- Combined colonic perforations are extremely rare, highlighting the need for awareness.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes.
- As colonoscopy use increases, vigilance for its rare complications is essential.
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