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Mid-ileal perforation secondary to colonoscopy
H W Nemeh1, M R Ranzinger, J A Dutro
1Department of Surgery, Wright State University and Good Samaritan Hospital, Dayton, Ohio 45409.
The American Surgeon
|March 1, 1994
Summary
Colonoscopy can cause bowel perforation, though ileal perforation is extremely rare. This case highlights a unique instance of double ileal perforation due to severe pelvic adhesions after the procedure.
Area of Science:
- Gastroenterology
- Surgical Complications
- Endoscopy
Background:
- Colonoscopy is a standard diagnostic and therapeutic endoscopic procedure.
- Bowel perforation is a recognized, albeit infrequent, complication of colonoscopy.
- Ileal perforation is an exceptionally rare event during colonoscopy.
Observation:
- A patient developed a double ileal perforation following a colonoscopy procedure.
- The perforation was attributed to extensive and rigid pelvic adhesions.
- This represents a previously undocumented presentation of colonoscopy-induced injury.
Findings:
- Dense pelvic adhesions can significantly increase the risk of iatrogenic injury during colonoscopy.
- The anatomical distortion caused by adhesions predisposed the ileum to perforation.
- A double perforation indicates a complex injury pattern in this specific context.
Implications:
- Clinicians should consider the risk of rare complications like ileal perforation in patients with significant pelvic adhesions.
- Pre-procedural assessment for adhesions may be crucial in select cases.
- This case expands the understanding of potential colonoscopy-related injuries and their contributing factors.