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Right pneumothorax secondary to colonoscopic perforation: a case
Il Giornale Di Chirurgia
|December 20, 2018
Summary
Pneumothorax is a rare but life-threatening complication of colonoscopy. Prompt diagnosis with imaging and urgent treatment, including chest tube insertion, are crucial for patient survival.
Area of Science:
- Gastroenterology
- Thoracic Surgery
- Diagnostic Imaging
Background:
- Colonoscopy is a common endoscopic procedure for colorectal examination.
- Complications, though rare, can include gastrointestinal perforation.
- Pneumothorax, a serious adverse event, necessitates understanding its mechanisms and management.
Observation:
- A case of sigmoid colon perforation during colonoscopy led to pneumoperitoneum.
- Gas dissection through diaphragmatic fenestration resulted in right-sided pneumothorax.
- This highlights the potential for extraperitoneal air tracking.
Findings:
- Colonic perforation can lead to extraperitoneal air spread, causing pneumoretroperitoneum, pneumomediastinum, and pneumothorax.
- Pneumothorax following colonoscopy sigmoid perforation is extremely rare but severe.
- Subcutaneous emphysema and pneumopericardium are also potential sequelae.
Implications:
- Patients with dyspnea or pneumoderma post-colonoscopy require immediate imaging (chest X-ray or CT).
- Urgent interventions like chest tube insertion and surgical exploration (laparotomy/laparoscopy) can be lifesaving.
- Awareness of this rare complication is vital for timely diagnosis and management.
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