Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted Colonoscopy
We present a case of explosive vomiting associated with the extensive manipulation of the proximal colon during a difficult colonoscopy procedure. The cause of vomiting in this case may have been multifactorial; however, proximal colonic distention was the most likely factor because the onset of vom...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2019/6960493 |
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| author | Kang H. Rah William Ferges James Tse |
| author_facet | Kang H. Rah William Ferges James Tse |
| author_sort | Kang H. Rah |
| collection | DOAJ |
| description | We present a case of explosive vomiting associated with the extensive manipulation of the proximal colon during a difficult colonoscopy procedure. The cause of vomiting in this case may have been multifactorial; however, proximal colonic distention was the most likely factor because the onset of vomiting coincided with proximal colonic manipulation and happened without any prodromal signs, coughing, and airway obstruction. Propofol, the sedative most commonly administered to the patient during colonoscopy, allows for a deep state of sedation, and consequently extensive colonic distention and scope manipulation. Colonic distention may lead to a higher risk of vomiting. We reviewed the neurocircuitry associated with vomiting and discussed why proximal colonic distention may increase the risk of vomiting. We emphasize vigilance during the manipulation of the proximal colon because vomiting increases the potential for aspiration pneumonitis and pneumonia in patients under deep propofol sedation with attenuated airway responses. |
| format | Article |
| id | doaj-art-04a8c65111244782b965611e2651b80d |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-04a8c65111244782b965611e2651b80d2025-02-03T06:06:07ZengWileyCase Reports in Anesthesiology2090-63822090-63902019-01-01201910.1155/2019/69604936960493Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted ColonoscopyKang H. Rah0William Ferges1James Tse2The Rutgers State University of New Jersey, 714 Thistle Hill Lane, Somerset, NJ 08873, USAThe Digestive Disease Center of New Jersey, 33 Clyde Road, Suite 102, Somerset NJ 08873, USAAnesthesiology and Perioperative Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson St. CAB 3100, New Brunswick, NJ 08901, USAWe present a case of explosive vomiting associated with the extensive manipulation of the proximal colon during a difficult colonoscopy procedure. The cause of vomiting in this case may have been multifactorial; however, proximal colonic distention was the most likely factor because the onset of vomiting coincided with proximal colonic manipulation and happened without any prodromal signs, coughing, and airway obstruction. Propofol, the sedative most commonly administered to the patient during colonoscopy, allows for a deep state of sedation, and consequently extensive colonic distention and scope manipulation. Colonic distention may lead to a higher risk of vomiting. We reviewed the neurocircuitry associated with vomiting and discussed why proximal colonic distention may increase the risk of vomiting. We emphasize vigilance during the manipulation of the proximal colon because vomiting increases the potential for aspiration pneumonitis and pneumonia in patients under deep propofol sedation with attenuated airway responses.http://dx.doi.org/10.1155/2019/6960493 |
| spellingShingle | Kang H. Rah William Ferges James Tse Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted Colonoscopy Case Reports in Anesthesiology |
| title | Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted Colonoscopy |
| title_full | Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted Colonoscopy |
| title_fullStr | Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted Colonoscopy |
| title_full_unstemmed | Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted Colonoscopy |
| title_short | Explosive Vomiting Associated with Proximal Colonic Distention during a Difficult Propofol-Assisted Colonoscopy |
| title_sort | explosive vomiting associated with proximal colonic distention during a difficult propofol assisted colonoscopy |
| url | http://dx.doi.org/10.1155/2019/6960493 |
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