ABSTRACT
OBJECTIVE: the aim of this retrospective study was to evaluate the incidence of colon perforations from diagnostic and therapeutic colonoscopies, and to assess their management in our hospital. PATIENTS AND METHOD: perforations resulting from colonoscopy in our hospital were reviewed for the period January, 1991 to December, 2006. The study analyzed: purpose of procedure, lesion mechanisms, clinical and radiological presentations, delays in diagnosis, patient status, therapeutic handling, and outcome. RESULT: fifteen perforations (0.09%) (9 males and 6 females) out of a total of 16,285 colonoscopies carried out were seen to have taken place during the study period. Nine of these occurred after diagnostic colonoscopies, and 6 occurred after therapeutic endoscopies. Around 60% of perforations were detected by the endoscopist while carrying out the procedure (88.6% during diagnostic endoscopy, and 16.6% during therapeutic endoscopy). In 73.7% of cases abdominal pain and distension were the most frequent symptoms; extraluminal gas was seen in 100% of cases with imaging techniques. Delayed diagnosis (> 24 hours) occurred in 40% of patients (range: 1-6 days). Twelve patients were operated upon (80%), of whom 4 were ASA II and 8 were ASA III/IV. Postoperative morbidity was 44.44%, and mortality was 25%. The outcome of patients receiving conservative treatment was found to be satisfactory. CONCLUSION: perforation of the colon during colonoscopy is a rare complication with serious -even lethal- consequences. Conservative treatment can be provided for selected cases under strict clinical control. Type of surgery will depend on the lesion location and size, concomitant colon pathology, and degree of fecal contamination. Mortality seems to be related to general status rather than the surgical technique used.
Subject(s)
Colon/injuries , Colonoscopy/adverse effects , Intestinal Perforation/etiology , Adult , Aged , Aged, 80 and over , Female , Humans , Incidence , Intestinal Perforation/epidemiology , Intestinal Perforation/surgery , Male , Middle Aged , Retrospective StudiesABSTRACT
No disponible
Subject(s)
Male , Aged , Humans , Cholangiopancreatography, Endoscopic Retrograde/adverse effects , Pneumoperitoneum/etiology , Iatrogenic Disease , Intestinal Perforation/etiologyABSTRACT
This is the case of a 56-year-old male who presented at our Emergency Room complaining of severe epigastric pain that radiated towards the left shoulder and neck. Pneumopericardium was diagnosed with plain chest X-rays, which indicated a gastropericardial fistula. A contrast X-ray film was taken using a water-soluble contrast. A full gastrectomy was performed with esophagojejunostomy reconstruction and pericardial drainage, which resulted in a favourable patient outcome.
Subject(s)
Fistula/diagnostic imaging , Fistula/etiology , Gastric Fistula/complications , Gastric Fistula/diagnostic imaging , Pericardium/diagnostic imaging , Pneumopericardium/diagnostic imaging , Pneumopericardium/etiology , Drainage , Esophagostomy , Fistula/surgery , Gastrectomy , Gastric Fistula/surgery , Humans , Jejunostomy , Male , Middle Aged , Pericardium/surgery , Pneumopericardium/surgery , RadiographyABSTRACT
Presentamos el caso de un varón de 56 años que acude a Urgencias por un cuadro de dolor epigástrico irradiado a hombro izquierdo y a cuello. El diagnóstico de pneumopericardio fue realizado tras una radiografía simple de tórax confirmándose una fístula gastropericárdica con la realización de un tránsito con contraste hidrosoluble. Fue tratado quirúrgicamente practicándose gastrectomía total con reconstrucción esofagoyeyunal y drenaje pericárdico, siendo su evolución favorable
This is the case of a 56-year-old male who presented at our Emergency Room complaining of severe epigastric pain that radiated towards the left shoulder and neck. Pneumopericardium was diagnosed with plain chest X-rays, which indicated a gastropericardial fistula. A contrast X-ray film was taken using a watersoluble contrast. A full gastrectomy was performed with esophagojejunostomy reconstruction and pericardial drainage, which resulted in a favourable patient outcome
Subject(s)
Male , Middle Aged , Humans , Pneumopericardium/etiology , Gastric Fistula/complications , Gastrectomy , Pericardial Effusion/etiology , DrainageSubject(s)
Gastric Dilatation/complications , Portal Vein/diagnostic imaging , Vascular Diseases/etiology , Acute Disease , Aged , Gases , Gastric Dilatation/diagnostic imaging , Gastric Dilatation/therapy , Humans , Male , Portal Vein/pathology , Radiography , Treatment Outcome , Vascular Diseases/diagnostic imaging , Vascular Diseases/therapyABSTRACT
No disponible
Subject(s)
Male , Humans , Aged , Vascular Diseases , Portal Vein , Acute Disease , Gases , Treatment Outcome , Gastric DilatationABSTRACT
We report a case of leiomyosarcoma of the lower segment of the inferior vena cava in a fifty nine year old man who presented with bilateral leg edema on physical exploration. Ultrasonography, computed tomography scan and intravenous urography demonstrated the existence of a retroperitoneal tumour. The tumour and the affected venous fragment were resected. Postoperative radiotherapy was given. The patient was re-operated on three years later because of extra-local recurrence. Two years later the patient is assymptomatic and without radiological evidence of recurrence and/ or metastasis.
