Tension pneumothorax secondary to colonic perforation during diagnostic colonoscopy: report of a case.

Surgery Today
Chad G BallPaul Boiteau

Abstract

We report a case of tension pneumothorax, which occurred secondary to colonic perforation during a colonoscopy. The patient was a 77-year-old woman in whom acute respiratory decompensation developed suddenly during a diagnostic colonoscopy for iron deficiency anemia. We diagnosed bilateral pneumothoraces, tension pneumothorax, pneumomediastinum, pneumoperitoneum, and emphysema of the face, neck, and chest. At laparotomy, a posterior colonic perforation was identified at the site of an ileocolic anastomosis performed 3 years earlier. We performed a primary repair and the patient was discharged from hospital 12 days later. Although diagnostic colonoscopy-induced intestinal perforation is rare, it is the most common and serious complication associated with this procedure. Occasionally, air spreads from the retroperitoneum into continuous tissue planes and decompresses into the adjacent structures. To our knowledge, this is the first report of two unique manifestations of diagnostic colonoscopy-induced intestinal perforation: tension pneumothorax and perforation at the site of a previous anastomosis. Both of these conditions should be considered in the event of acute respiratory failure in the endoscopy suite.

References

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Citations

Sep 1, 2014·Radiologic Clinics of North America·Barry DalyDouglas S Katz
Feb 5, 2009·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·A RingJ Stern
Jul 3, 2013·Case Reports in Emergency Medicine·Ali Pourmand, Hamid Shokoohi
Sep 29, 2009·Revista brasileira de anestesiologia·Magda Lourenço FernandesMárcia Rodrigues Neder Issa
Apr 11, 2017·Clinical Endoscopy·Ajay GuptaKhalid Habib
Sep 22, 2017·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Hee Sung LeeHyun Yong Jeong

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