A case of iatrogenic colon penetration recovering by conservative treatment

Abstract

Recently. polypectomy using colonoscopy has been becoming general procedure. But colonoscopy has some complications of bleeding and perforation. We report a case of iatrogenic colon penetration recovering by conservative treatment. A 61-year-old male was admitted to our hospital for treatment of transverse colon tumor. Lower GI series, colonoscopy and Endoscopic ultrasoundsonography showed a giant large intestinal lipoma in Transverse colon. The spherical lesion was 50mm in diameter with a stalk. Polypectomy using colonoscopy was performed. Penetration was suspected by abdominal X-ray immediately after polypectomy. But abdominal pain was localized and the inflammatory change was not increased rapidly. Therefore penetration was treated conservatively. The extra colon gas was existed in the mesenterium and retroperitoneum, but fluid collection was not observed in the abdomen by computed tomography. The change of the extra colon gas observating by abdominal X-ray and computed tomography was decrease from 2^nd days after polypectomy using colonoscopy. The inflammatory change was in the normal range after 4^th postpolypectomy day, and the patient could begin drinking after 6^th postpolypectomy day and eating the foods after 8^th postpolypectmy day. After that, the course was uneventful, the patient was discharged from hospital on 12^th postplypectomy day. The penetration was successfully treated conservatively. We considered that treatment of penetration in colon was not always surgical operation.