Cold loop polypectomy perforation of a tiny colon polyp

Abstract

Cold loop polypectomy perforation of a tiny colon polyp. Rev Esp Enferm Dig 2021.

Delayed perforation after cold snare polypectomy for small colonic polyps in a patient receiving oral corticosteroids

“…In Figure 1c, a large hematoma appears after excision, which is considered to be one of the causes of perforation. We also found focal microbleeding not only in the polyp at the perforation site but also in other polyps, similar to the aforementioned report 4 . These findings may indicate capillary fragility.…”

“…10 Another case report of CSP perforation in a corticosteroid-treated patient described no significant histological findings, such as thinning or weakness of the intestinal wall, but they found focal microbleeding in the polyp. 4 It is known that subcutaneous bleeding caused by capillary vessel weakness is often seen in Cushing's syndrome, a chronic glucocorticoid surplus. Whether endogenous or exogenous, the capillary fragility caused by corticosteroids predisposes patients to bleed, and even minor tissue damage, such as that from CSP, can cause unexpected bleeding.…”

“…We also found focal microbleeding not only in the polyp at the perforation site but also in other polyps, similar to the aforementioned report. 4 These findings may indicate capillary fragility.…”

“…The authors reasoned that the perforation was due to intestinal ischemic changes 10 . Another case report of CSP perforation in a corticosteroid‐treated patient described no significant histological findings, such as thinning or weakness of the intestinal wall, but they found focal microbleeding in the polyp 4 …”

“…1 The European Society of Gastrointestinal Endoscopy's latest clinical guideline recommends CSP as the preferred technique for removing diminutive polyps, 2 and CSP is considered the standard method for resecting small polyps. 3 Although several cases of perforation after CSP have been reported, 4,5 no case of delayed perforation has been published in the literature. In this report, we describe a case of delayed perforation after CSP.…”