Endoscopic Vacuum Therapy for Iatrogenic Rectal Perforation
Serious iatrogenic bowel injuries during screening colonoscopy are rare events. If a perforation is detected during colonoscopy, endoscopic therapy can be attempted depending on the size and type as well as local endoscopic experience. We report the case of a 54-year-old female patient who was treat...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2022-06-01
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| Series: | Case Reports in Gastroenterology |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/525402 |
| _version_ | 1818048312589156352 |
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| author | Malte Zumblick Petros Stathopoulos Thomas Mathias Gress Ulrike Walburga Denzer |
| author_facet | Malte Zumblick Petros Stathopoulos Thomas Mathias Gress Ulrike Walburga Denzer |
| author_sort | Malte Zumblick |
| collection | DOAJ |
| description | Serious iatrogenic bowel injuries during screening colonoscopy are rare events. If a perforation is detected during colonoscopy, endoscopic therapy can be attempted depending on the size and type as well as local endoscopic experience. We report the case of a 54-year-old female patient who was treated by endoscopic vacuum therapy (EVT) for a rectal perforation she had suffered during an outpatient screening colonoscopy. Two hours after the complication, an emergency endoscopy was performed. A perforation of the lower third of the rectum with a longitudinal diameter of 4 cm and a depth of 2.5 cm was detected. Due to the deep defect and the suspected increased risk of abscess formation after mechanical perforation closure with endoclips, we decided to perform EVT. The therapy was performed over a total period of 7 days. The patient was symptom free at all times. On the 2nd and 5th day, the endoscopic findings were re-evaluated and the inserted endosponges were changed. The sponge was adjusted to the wound conditions at each check and its length was gradually shortened. The endoscopic findings improved steadily. The EVT was completed after 7 days with the result of complete wound closure. The inflammatory parameters dropped continuously from day 1. On day 8, the patient could be discharged from inpatient treatment. No complications occurred in the post-inpatient course. This case is an example of successful EVT after iatrogenic rectal perforation. EVT should be considered for iatrogenic rectal perforation when signs of systemic inflammation are present and primary mechanical wound closure appears critical due to the depth of the defect and the presumed risk of abscess formation. |
| first_indexed | 2024-12-10T10:19:41Z |
| format | Article |
| id | doaj.art-d3dc6423f1fc4b7eac93c014758de862 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-12-10T10:19:41Z |
| publishDate | 2022-06-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-d3dc6423f1fc4b7eac93c014758de8622022-12-22T01:52:55ZengKarger PublishersCase Reports in Gastroenterology1662-06312022-06-0116242542910.1159/000525402525402Endoscopic Vacuum Therapy for Iatrogenic Rectal PerforationMalte ZumblickPetros Stathopouloshttps://orcid.org/0000-0003-2637-8346Thomas Mathias Gresshttps://orcid.org/0000-0002-9333-5461Ulrike Walburga DenzerSerious iatrogenic bowel injuries during screening colonoscopy are rare events. If a perforation is detected during colonoscopy, endoscopic therapy can be attempted depending on the size and type as well as local endoscopic experience. We report the case of a 54-year-old female patient who was treated by endoscopic vacuum therapy (EVT) for a rectal perforation she had suffered during an outpatient screening colonoscopy. Two hours after the complication, an emergency endoscopy was performed. A perforation of the lower third of the rectum with a longitudinal diameter of 4 cm and a depth of 2.5 cm was detected. Due to the deep defect and the suspected increased risk of abscess formation after mechanical perforation closure with endoclips, we decided to perform EVT. The therapy was performed over a total period of 7 days. The patient was symptom free at all times. On the 2nd and 5th day, the endoscopic findings were re-evaluated and the inserted endosponges were changed. The sponge was adjusted to the wound conditions at each check and its length was gradually shortened. The endoscopic findings improved steadily. The EVT was completed after 7 days with the result of complete wound closure. The inflammatory parameters dropped continuously from day 1. On day 8, the patient could be discharged from inpatient treatment. No complications occurred in the post-inpatient course. This case is an example of successful EVT after iatrogenic rectal perforation. EVT should be considered for iatrogenic rectal perforation when signs of systemic inflammation are present and primary mechanical wound closure appears critical due to the depth of the defect and the presumed risk of abscess formation.https://www.karger.com/Article/FullText/525402case reportrectal perforationendoscopic vacuum therapy |
| spellingShingle | Malte Zumblick Petros Stathopoulos Thomas Mathias Gress Ulrike Walburga Denzer Endoscopic Vacuum Therapy for Iatrogenic Rectal Perforation Case Reports in Gastroenterology case report rectal perforation endoscopic vacuum therapy |
| title | Endoscopic Vacuum Therapy for Iatrogenic Rectal Perforation |
| title_full | Endoscopic Vacuum Therapy for Iatrogenic Rectal Perforation |
| title_fullStr | Endoscopic Vacuum Therapy for Iatrogenic Rectal Perforation |
| title_full_unstemmed | Endoscopic Vacuum Therapy for Iatrogenic Rectal Perforation |
| title_short | Endoscopic Vacuum Therapy for Iatrogenic Rectal Perforation |
| title_sort | endoscopic vacuum therapy for iatrogenic rectal perforation |
| topic | case report rectal perforation endoscopic vacuum therapy |
| url | https://www.karger.com/Article/FullText/525402 |
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