The unusual case of the irretrievable colonoscope

Abstract

Key Clinical MessageIt is important that invasive procedures are rationalized, even relatively safe ones like colonoscopy, to minimize the risk of harm to patients.

A stuck colonoscope in the chest cavity: An uncommon complication

“…An irretrievable colonoscope secondary to looping is an exceedingly rare complication of colonoscopy; the presence of previous abdominal surgery is a risk factor for the procedural difficulty and incompleteness. [1][2][3] Significant looping and angulations are reported to cause the colonoscope to be difficult to advance or retrieve, requiring a laparotomy to withdraw it. 2,3,5 In this case report, the rare complication of colonoscope's migration in the chest cavity was associated with the presence of a late TDH.…”

“…[1][2][3] Significant looping and angulations are reported to cause the colonoscope to be difficult to advance or retrieve, requiring a laparotomy to withdraw it. 2,3,5 In this case report, the rare complication of colonoscope's migration in the chest cavity was associated with the presence of a late TDH. The TDH is more commonly associated with a blunt abdominal injury like road traffic accident and fall from height when compared with penetrating abdominal injuries and has higher tendency to increase in size and include abdominal organs as the increasing abdominal pressure causes the abdominal content to herniate into the pleural cavity, which has relatively lower pressure.…”

“…The literature shows few cases reported of colonoscopes being stuck in incarcerated hernias, which required surgical management and none of the reported cases were diaphragmatic hernias. 2,3,5 F I G U R E 1 A, Fluoroscopy revealing the scope inside the chest cavity. B, Computed tomography scan shows a left-sided diaphragmatic hernia; the colonoscope is observed inside a bowel loop (red arrow)…”

“…Although the colonoscopy is a routine and safe procedure, performed widely for diagnostic and therapeutic purposes, rare complications are possible, and they vary from minor abdominal symptoms to more serious complications. 1 The event of an irretrievable or stuck colonoscope is a very rare complication of colonoscopy, which requires urgent treatment, 2,3 and often related to anatomic variations on the abdominal viscera.…”