Pneumoperitoneum, pneumomediastinum and subcutaneous emphysema following argon plasma coagulation treatment of colonic angioectasia

Česká verzia

Authors: P. Horák ¹; M. Peregrinová ²; A. Erbenová ¹; T. Žižková ¹; J. Fulík ¹; J. Fanta ¹
Authors place of work: Chirurgická klinika Fakultní nemocnice Bulovka a 1. lékařská fakulta Univerzity Karlovy, Praha ¹; Oddělení gastroenterologie, Medicon, a. s., Praha ²
Published in the journal: Rozhl. Chir., 2023, roč. 102, č. 3, s. 130-133.
Category: Case Report
doi: https://doi.org/10.33699/PIS.2023.102.3.130–133

Summary

Introduction: The paper presents unusual symptoms as a complication of therapeutic colonoscopy.

Case report: A 70-year-old polymorbid female patient in chronic dialysis program underwent argon plasma coagulation treatment of leaking angioectasias in the cecum and ascending colon. Shortly after the procedure she presented with shortness of breath and subcutaneous emphysema of the neck which was initially misdiagnosed as swelling. Further tests revealed pneumoperitoneum, subcutaneous emphysema and pneumomediastinum. Considering the high risks for our patient (comorbidities, obesity), a laparoscopic approach was indicated. During laparoscopy neither peritonitis nor intestinal perforation were found. The patient recovered without complications after further complex treatment.

Conclusion: Shortness of breath and subcutaneous emphysema are not typically among the first symptoms of colonoscopic perforation. Our case confirms that we should bear this complication in mind and when suspected, the diagnostic process should be started without delay.

Keywords:

subcutaneous emphysema – pneumoperitoneum – argon plasma coagulation – iatrogenic colonoscopic perforation

Zdroje

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