Challenges in the Endoscopic Management of a Delayed Colonic Perforation After Polypectomy

A 63-year-old woman underwent screening colonoscopy with diathermic snare polypectomy of a 25mm sigmoid’s pedunculated polyp featuring deep mural injury without perforation. 10hours later, she presented with abdominal pain and fever. Abdominal-CT showed contained colonic perforation without free pneumoperitoneum or peritoneal effusion. After multidisciplinary discussion, endoscopic closure using OTSC (Ovesco,Germany) was performed 14hours after presentation. 2weeks later abdominal pain recurred due to a 7cm peri-sigmoid collection related to partial OTSC dehiscence. After lavage, complete closure was performed using a modified tulip-bundle technique joining the previously placed OTSC with additional TTS-endoclips tighten by an endoloop. Uneventful recovery was finally achieved.

Citation: Macedo C, Gravito-Soares E, Gravito-Soares M et al. eP214V CHALLENGES IN THE ENDOSCOPIC MANAGEMENT OF A DELAYED COLONIC PERFORATION AFTER POLYPECTOMY. Endoscopy 2021; 53: S169.

Publication History

Article published online:
19 March 2021