World Journal of Laparoscopic Surgery

Register      Login

VOLUME 7 , ISSUE 3 ( September-December, 2014 ) > List of Articles

CASE REPORT

Scoliosis as a Rare Risk Factor for Colon Perforation during Colonoscopy: The Second Reported Case and Literature Review

Sameer AlOsaimi, Shehab Ekrouf, Ahmed AlMulla

Citation Information : AlOsaimi S, Ekrouf S, AlMulla A. Scoliosis as a Rare Risk Factor for Colon Perforation during Colonoscopy: The Second Reported Case and Literature Review. World J Lap Surg 2014; 7 (3):133-135.

DOI: 10.5005/jp-journals-10033-1234

Published Online: 00-12-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background

Colonoscopy has been accepted as the best method for the screening, diagnosis, treatment and follow-up of colorectal pathologies. It is an invasive procedure with many recognized complications such as iatrogenic colonic perforation (CP). Knowledge of the factors influencing (CP) is of decisive importance, especially with regard to the avoidance or minimization of the perforations. This is the second case in the literature with such unreported and rare risk factor for iatrogenic colonoscopic perforation.

Case summary

We reported a 66-year-old female, not known to have any medical problems, underwent colonoscopy screening. No abnormalities detected up to the rectosigmoid junction when the gastroenterologist noted sudden and massive abdominal distension, the patient started com- plaining of severe generalized abdominal pain, however, she was hemodynamically stable. The procedure abandoned. Abdominal X-ray showed severe scoliotic deformity of the lumber spine with massive pneumoperitoneum. Diagnostic laparoscopy showed a small perforation at the anterior wall of sigmoid colon which was repaired, no fecal soiling of the peritoneal cavity was found as she was prepared for colonoscopy. Her course was unremarkable, and she was discharged 7 days later. A 2-week follow-up showed her to be asymptomatic with healed laparoscopic surgery scars and normal bowel motion.

Conclusion

Patients with skeletal deformity such as scoliosis undergoing colonoscopy have a higher risk of iatrogenic colonoscopic perforation. Symptoms of abdominal pain and distension during colonoscopy in this group of patients should alert the treating doctor for the possibility of colon injury which should be managed accordingly.

How to cite this article

AlOsaimi S, Ekrouf S, AlMulla A. Scoliosis as a Rare Risk Factor for Colon Perforation during Colonoscopy: The Second Reported Case and Literature Review. World J Lap Surg 2014;7(3):133-135.


PDF Share
  1. Complications of flexible fiberoptic colonoscopy and polypectomy. Gastrointest Endosc 1975;22:73-77.
  2. Fiberoptic colonoscopy: complications of colonoscopy and polypectomy. Dis Colon Rectum 1976;19:407-412.
  3. Dig Dis Sci 2008.
  4. Complications of fiberoptic endoscopy. Gastrointest Endosc 1980;26:86-91.
  5. Complications of therapeutic gastrointestinal endoscopy. Endoscopy 1992;24:276-283.
  6. Laparoscopic treatment of colonic perforations related to colonoscopy. Surg Endosc 1999;13:484-487.
  7. What are the risk factors of colonoscopic perforation? BMC Gastroenterol 2009;9:71.
  8. Endoscopic mucosal resection for early colorectal neoplasia: pathologic basis, procedures and outcomes. Dis Colon Rectum 2009;52:1502-1515.
  9. Surgical management and outcomes of 165 colonoscopic perforations from a single institution. Arch Surg 2008;143:701-706.
  10. Outcomes and predictors of mortality and stoma formation in surgical management of colonoscopic perforations: a multicenter review. Arch Surg 2009;144:9-13.
  11. Colonoscopic perforations: a review of 30,366 patients. Surg Endosc 2007;21:994-997.
  12. The munich polypectomy study (MUPS): prospective analysis of complications and risk factors in 4,000 colonic snare polypectomies. Endoscopy 2005;37:1116-1122.
  13. Scoliosis as a rare risk factor for colon perforation during colonoscopy: a case report. Kuwait University, Health Sciences Center (HSC), Poster Conference 2010. Poster No. 272.
  14. Scoliosis as a rare risk factor for colon perforation during colonoscopy: a case report. KMJ. Submitted for publishing.
  15. Endoscopic perforation of the colon: lessons from a 10-year study. Am J Gastroenterol 2000;95:3418-3422.
  16. Risk of perforation after colonoscopy and sigmoidoscopy: a population-based study. J Natl Cancer Inst 2003;95:230-236.
  17. What are the risk factors of colonoscopic perforation? BMC Gastroenterol 2009;9:71.
  18. Colonoscopic perforations. Etiology, diagnosis and management. Dis Colon Rectum 1996;39:1308-1314.
  19. Risk of perforation from a colonoscopy in adults: a large population-based study. Gastrointest Endosc 2009;69:654-664.
  20. Impact of sedation and resident teaching on complications of colonoscopy. Dig Surg 1998;15(1):60-63.
  21. Colonoscopic perforations: incidence, management and outcomes. Am Surg 2004;70:750-757.
  22. Mini-perforation of the colon–not all postpolypectomy perforations require laparotomy. Dis Colon Rectum 1991;34:132-135.
  23. Complications in endoscopy of the lower gastrointestinal tract. Therapy and prognosis. Surg Endosc 1994;8:672-676.
  24. Selective management of colonoscopic perforations. J Am Coll Surg 1994;179:333-337.
  25. Complications of diagnostic and therapeutic colonoscopy within a defined population in Sweden. Gastrointest Endosc 2001 Sep;54(3):302-309.
  26. Laparoscopic repair of colonoscopic perforations: indications and guidelines. J Gastrointest Surg 2007;11:655-659.
  27. Management of colonoscopic perforations. Mayo Clin Proc 1997;72:729-733.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.