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Pneumoperitoneum after virtual colonoscopy: causes, risk factors, and management
Leopoldo M Baccaro1, Alexey Markelov, Jakub Wilhelm
1Department of General Surgery, Easton Hospital, Drexel University College of Medicine, Easton, Pennsylvania, USA.
The American Surgeon
|June 3, 2014
Summary
Computed tomographic virtual colonoscopy (CTVC) is a rare cause of colonic perforation. Reviewing 25 reported cases, risk factors and management strategies were identified to improve patient safety.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Innovation
Background:
- Computed tomographic virtual colonoscopy (CTVC) offers a safe, minimally invasive alternative to traditional colonoscopy for colorectal evaluation.
- Assessing the incidence and risk factors of colonic perforation during CTVC is crucial for patient safety.
Observation:
- A literature review identified 25 reported cases of colonic perforation following CTVC.
- Commonly associated risk factors include diverticular disease, inflammatory bowel disease, obstructions, malignancies, and iatrogenic causes.
Findings:
- Colonic perforation is a rare complication of CTVC.
- Both operative and nonoperative management approaches exist, with nonoperative management proving safe and effective for stable, minimally symptomatic patients.
Implications:
- Acknowledging recurrent risk factors during CTVC is essential for procedural safety.
- Tailored management strategies, considering individual patient stability and symptoms, are key for optimizing outcomes after CTVC-related perforation.
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