Year 2024 / Volume 116 / Number 10
Digestive Diseases Image
Colonic perforation after esophagogastroduodenoscopy: complications with self-expanding metallic stents

559-560

DOI: 10.17235/reed.2023.9547/2023

Koichi Soga,

Abstract
An 83-year-old man was admitted to the emergency room with abdominal pain and bloating. Abdominal computed tomography (CT) revealed a sigmoid colon obstruction caused by colonic carcinoma involving a short segment with circumferential luminal narrowing. The patient underwent endoscopy with colonic self-expanding metallic stent (SEMS) placement as a bridge to surgery. Six days after SEMS placement, the patient was prepared for esophagogastroduodenoscopy for screening. Although screening revealed no complications, 8 h later, the patient complained of sudden abdominal pain. Emergency abdominal CT revealed that the SEMS was about to burst out of the colon. An emergency operation with sigmoidectomy and colostomy was performed, and operative findings revealed a colonic perforation by the SEMS at the proximal side of the tumor. The patient was discharged from the hospital without major problems. This case is a very rare complication of colonic SEMS insertion. It is possible that increased intraluminal bowel movement and/or CO2 pressure during the esophagogastroduodenoscopy caused colonic perforation. Endoscopic placement of a SEMS is an effective alternative to surgical decompression for treating colon obstruction. To avoid unexpected and unnecessary perforations, tests that could increase the intraluminal pressure within the intestine after SEMS insertion should be avoided.
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References
1.van Hooft JE, Veld JV, Arnold D, et al. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2020. Endoscopy 2020; 52: 389–407
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Soga K. Colonic perforation after esophagogastroduodenoscopy: complications with self-expanding metallic stents. 9547/2023


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Publication history

Received: 21/02/2023

Accepted: 01/03/2023

Online First: 10/03/2023

Published: 09/10/2024

Article Online First time: 17 days

Article editing time: 596 days


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