Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case Report

Introduction: Cold snare polypectomy (CSP) is a procedure with a low risk of complications. Here, we present our experience of a rare case of submucosal abscess following CSP in an immunosuppressed patient. Case Presentation: Seventy-eight-year-old man underwent CSP, developing a fever, chills, and...

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Main Authors: Karen Kimura, Chikamasa Ichita, Chihiro Sumida, Takashi Nishino, Miki Nagayama, Jun Kubota, Haruto Hirose, Akiko Sasaki
Format: Article
Language:English
Published: Karger Publishers 2024-03-01
Series:Case Reports in Gastroenterology
Subjects:
Online Access:https://beta.karger.com/Article/FullText/536487
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author Karen Kimura
Chikamasa Ichita
Chihiro Sumida
Takashi Nishino
Miki Nagayama
Jun Kubota
Haruto Hirose
Akiko Sasaki
author_facet Karen Kimura
Chikamasa Ichita
Chihiro Sumida
Takashi Nishino
Miki Nagayama
Jun Kubota
Haruto Hirose
Akiko Sasaki
author_sort Karen Kimura
collection DOAJ
description Introduction: Cold snare polypectomy (CSP) is a procedure with a low risk of complications. Here, we present our experience of a rare case of submucosal abscess following CSP in an immunosuppressed patient. Case Presentation: Seventy-eight-year-old man underwent CSP, developing a fever, chills, and right lower abdominal pain 8 days later. Ultrasound and computed tomography revealed wall thickening of the ascending colon, presenting as whitening and thickening of the same region, and excretion of pus was observed after biopsy. The diagnosis was made as phlegmonous colitis, for which antibiotic therapy was commenced. The patient was diagnosed with chronic myelomonocytic leukemia (CMML) during admission. We considered the following reasons as possible causes of infectious complications after CSP: (1) the patient had a highly immunosuppressed state with comorbidities such as CMML as well as diabetes mellitus and (2) disruption of the mucosal barrier occurred during endoscopic resection. Conclusion: Although CSP is generally considered safe, our case highlights the potential for serious complications in immunosuppressed patients. Therefore, the decision to perform CSP in such patients should be made with caution to avoid unnecessary interventions. In instances where treatment is essential, thorough bowel preparation and prophylactic antibiotic use may be necessary to mitigate the risks.
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spelling doaj.art-28b616f3d0564a5b980720d1c70a50272024-04-04T06:12:57ZengKarger PublishersCase Reports in Gastroenterology1662-06312024-03-0118111011610.1159/000536487536487Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case ReportKaren Kimura0Chikamasa Ichita1Chihiro Sumida2Takashi Nishino3Miki Nagayama4Jun Kubota5Haruto Hirose6Akiko Sasaki7Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JapanGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JapanGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JapanGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JapanGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JapanGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JapanGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JapanGastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura, JapanIntroduction: Cold snare polypectomy (CSP) is a procedure with a low risk of complications. Here, we present our experience of a rare case of submucosal abscess following CSP in an immunosuppressed patient. Case Presentation: Seventy-eight-year-old man underwent CSP, developing a fever, chills, and right lower abdominal pain 8 days later. Ultrasound and computed tomography revealed wall thickening of the ascending colon, presenting as whitening and thickening of the same region, and excretion of pus was observed after biopsy. The diagnosis was made as phlegmonous colitis, for which antibiotic therapy was commenced. The patient was diagnosed with chronic myelomonocytic leukemia (CMML) during admission. We considered the following reasons as possible causes of infectious complications after CSP: (1) the patient had a highly immunosuppressed state with comorbidities such as CMML as well as diabetes mellitus and (2) disruption of the mucosal barrier occurred during endoscopic resection. Conclusion: Although CSP is generally considered safe, our case highlights the potential for serious complications in immunosuppressed patients. Therefore, the decision to perform CSP in such patients should be made with caution to avoid unnecessary interventions. In instances where treatment is essential, thorough bowel preparation and prophylactic antibiotic use may be necessary to mitigate the risks.https://beta.karger.com/Article/FullText/536487phlegmonous colitiscold snare polypectomyimmunosuppressed patientscase report
spellingShingle Karen Kimura
Chikamasa Ichita
Chihiro Sumida
Takashi Nishino
Miki Nagayama
Jun Kubota
Haruto Hirose
Akiko Sasaki
Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case Report
Case Reports in Gastroenterology
phlegmonous colitis
cold snare polypectomy
immunosuppressed patients
case report
title Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case Report
title_full Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case Report
title_fullStr Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case Report
title_full_unstemmed Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case Report
title_short Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case Report
title_sort phlegmonous colitis after cold snare polypectomy in an immunosuppressed patient a case report
topic phlegmonous colitis
cold snare polypectomy
immunosuppressed patients
case report
url https://beta.karger.com/Article/FullText/536487
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