Unanticipated adverse event of endoscopic submucosal dissection: Rectal perforation associated with injury of the cecum wall, Report of a case

Kazuo To; Hiroaki Takeshita; Kouki Wakata; Tetsuro Tominaga; Masaki Kunizaki; Takafumi Abo; Shigekazu Hidaka; Atsushi Nanashima; Terumitsu Sawai; Takeshi Nagayasu; Tadayuki Oka

doi:10.11343/amn.59.103

CASE REPORT

Unanticipated adverse event of endoscopic submucosal dissection: Rectal perforation associated with injury of the cecum wall, Report of a case

Kazuo To, Hiroaki Takeshita, Kouki Wakata, Tetsuro Tominaga, Masaki Kunizaki, Takafumi Abo, Shigekazu Hidaka, Atsushi Nanashima, Terumitsu Sawai, Takeshi Nagayasu, Tadayuki Oka

Author information

Kazuo To
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
Hiroaki Takeshita
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
Kouki Wakata
Department of Surgery, National Hospital Organization Ureshino Medical Center
Tetsuro Tominaga
Department of Surgery, National Hospital Organization Ureshino Medical Center
Masaki Kunizaki
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
Takafumi Abo
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
Shigekazu Hidaka
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
Atsushi Nanashima
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
Terumitsu Sawai
Division of Nursing, Nagasaki University, School of Health Science, Faculty of Medicine
Takeshi Nagayasu
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
Tadayuki Oka
Department of Surgery, National Hospital Organization Ureshino Medical Center

Keywords: adverse event, colorectal ESD, injury of other organ, laparoscopic surgery, rectal perforation, cecal injury

JOURNAL FREE ACCESS

2015 Volume 59 Issue 3 Pages 103-106

DOI https://doi.org/10.11343/amn.59.103

Details

Abstract

Endoscopic submucosal dissection (ESD) is a standard treatment for early gastric cancer, but it is not generally used for colorectal lesions because of its high risk of adverse events. An unanticipated adverse event of rectal ESD is reported. A 71-year-old man was found to have a laterally spreading tumor at the upper rectum. ESD was performed. During the ESD, rectal perforation occurred, and emergency laparoscopic surgery was performed. At the operation, rectal perforation with retroperitoneal emphysema was detected. Surprisingly, an 8-cm-long, lacerated wound was found at the cecum wall. It was thought to have been caused by heat injury due to ESD. The perforated site was resected, and the laceration of the cecum was repaired by extracorporeal suture. In patients with perforation during ESD, it is essential to keep in mind that other organs might have heat-induced injury, and the patient should be more carefully followed.

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