Postpolypectomy coagulation syndrome - an uncommon complication of colonoscopy

Kus, Joseph; Haque, Saem; Kazan-Tannus, Joao Fernando; Jawahar, A.

doi:10.1016/j.clinimag.2021.04.037

Cited by 11 publications

(9 citation statements)

References 9 publications

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“…Management involves hydration, antibiotics, and bowel rest until symptoms settle. 15 We acknowledge the similarities in clinical presentation between PPCS and PCD, and some features that may help differentiate between these 2 entities are as follows: PPCS is typically associated with larger or challenging-to-remove polyps with aggressive electrocoagulation techniques. In our first case, all polyps were small and resected with cold polypectomy.…”

Section: Discussionmentioning

confidence: 99%

Postcolonoscopy Diverticulitis

Essam,

Beintaris,

Rutter

2024

ACG Case Rep J

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Colonoscopy, generally safe but not devoid of risks, can lead to rare complications. We present 2 cases of postcolonoscopy diverticulitis (PCD). Case 1 was a 63-year-old woman, following colonoscopy, who developed acute sigmoid diverticulitis, despite a Diverticular Inflammation and Complication Assessment (DICA) score of 2, indicating extensive diverticulosis without inflammation. Conservative management with antibiotics led to recovery. Remarkably, she experienced a recurrent episode. Case 2 was a 74-year-old woman who had 2 colonoscopies, revealing pancolonic diverticulosis (DICA score: 2) without inflammation. After the second procedure, she developed severe sigmoid diverticulitis, managed conservatively with antibiotics. Discussion highlights PCD's rarity (prevalence: 0.04%–0.08%) and unclear pathogenesis. Both cases had DICA scores ≥2, suggesting a potential risk factor. Clinicians should recognize PCD, as it can mimic more common postcolonoscopy complications. Early recognition and management are vital.

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Section: Discussionmentioning

confidence: 99%

Postcolonoscopy Diverticulitis

Essam,

Beintaris,

Rutter

2024

ACG Case Rep J

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“…PPCS, a rare and serious complication of colonoscopic polypectomy, results from an electrocoagulation injury to the bowel wall during polypectomy, which induces a transmural burn and localized peritoneal inflammation without clinical evidence of perforation on radiographic examination [ 13 ]. Within hours to 5 days after colonoscopic polypectomy, patients develop fever and other symptoms, including leukocytosis, localized abdominal pain and localized peritoneal signs.…”

Section: Discussionmentioning

confidence: 99%

Postpolypectomy fever in patients with serious infection: a report of two cases

Wang

Yang

2022

BMC Gastroenterol

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Background Postpolypectomy fever (PPF) is a rare complication in patients after colonoscopy. Because of the absence of evidence of microperforation and abdominal tenderness, patients with PPF usually present mild clinical symptoms with a good prognosis. Case presentation In this study, all patients who underwent colonoscopic examination in our hospital between January 2019 and December 2019 were enrolled. Of these, two patients developed PPF after polypectomy, exhibiting serious infection without definitive fever foci. One patient experienced rapidly aggravated type 1 respiratory failure and abnormal hepatic function, which were attributed to colonoscopy-associated infection. After active antibiotic therapy, both patients were discharged without any complications. Conclusions In summary, our study provides novel insights into patients with PPF who develop serious infections with life-threatening complications.

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“…Postpolypectomy syndrome (PPS) is a rare postoperative complication that occurs several days after colonic polypectomy[ 1 , 2 ]. Patients with PPS may pathologically develop serosal inflammation and coagulopathy because of a transmural burn and focal peritonitis following electrocoagulation of a portion of the bowel wall during polypectomy[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Postpolypectomy syndrome without abdominal pain led to sepsis/septic shock and gastrointestinal bleeding: A case report

Chen,

Ouyang,

Zhong

et al. 2023

World J Gastrointest Surg

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Postcholecystectomy bile duct injury (BDI) remains a devastating iatrogenic complication that adversely impacts the quality of life with high healthcare costs. Despite a decrease in the incidence of laparoscopic cholecystectomy-related BDI, the absolute number remains high as cholecystectomy is a commonly performed surgical procedure. Open Roux-en-Y hepaticojejunostomy with meticulous surgical technique remains the gold standard surgical procedure with excellent long-term results in most patients. As with many hepatobiliary disorders, a minimally invasive approach has been recently explored to minimize access-related complications and improve postoperative recovery. Since patients with gallstone disease are often admitted for a minimally invasive cholecystectomy, laparoscopic and robotic approaches for repairing postcholecystectomy biliary stricture are attractive. While recent series have shown the feasibility and safety of minimally invasive post-cholecystectomy biliary stricture management, most are retrospective analyses with small sample sizes. Also, long-term follow-up is available only in a limited number of studies. The principles and technique of minimally invasive repair resemble open repair except for the extent of adhesiolysis and the suturing technique with continuous sutures commonly used in minimally invasive approaches. The robotic approach overcomes key limitations of laparoscopic surgery and has the potential to become the preferred minimally invasive approach for the repair of postcholecystectomy biliary stricture. Despite increasing use, lack of prospective studies and selection bias with available evidence precludes definitive conclusions regarding minimally invasive surgery for managing postcholecystectomy biliary stricture. High-volume prospective studies are required to confirm the initial promising outcomes with minimally invasive surgery.

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Postpolypectomy coagulation syndrome - an uncommon complication of colonoscopy

Cited by 11 publications

References 9 publications

Postcolonoscopy Diverticulitis

Postcolonoscopy Diverticulitis

Postpolypectomy fever in patients with serious infection: a report of two cases

Postpolypectomy syndrome without abdominal pain led to sepsis/septic shock and gastrointestinal bleeding: A case report

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