Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy
Colonoscopy is widely accepted as the gold-standard screening technique for detecting malignancies in the distal gastrointestinal tract in patients with symptoms suggestive of colon cancer. However, this procedure is not without risk, including colonic perforation. We report a patient who was manage...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2013/695318 |
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| author | Oliver J. Ziff A. M. James Shapiro |
| author_facet | Oliver J. Ziff A. M. James Shapiro |
| author_sort | Oliver J. Ziff |
| collection | DOAJ |
| description | Colonoscopy is widely accepted as the gold-standard screening technique for detecting malignancies in the distal gastrointestinal tract in patients with symptoms suggestive of colon cancer. However, this procedure is not without risk, including colonic perforation. We report a patient who was managed conservatively after colonoscopy induced perforation. Eighteen months after appearing to make a full recovery, he presented with an upper gastrointestinal bleed. Oesophago-gastro-duodenoscopy (OGD) revealed large gastric fundal varices and computed tomography (CT) revealed splenic vein thrombosis. The ensuing left-sided (sinistral) hypertension explains the development of the fundal varices in the presence of normal liver function. At surgery, a persistent abscess cavity was identified and cultures from this site grew Streptococcus anginosus. Curative splenectomy was performed and the patient made a full recovery. We advocate more prompt operative intervention in selected cases of iatrogenic colonic perforation with primary repair to prevent late complications. |
| format | Article |
| id | doaj-art-f0195f3e3851408dad433fecde92e795 |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-f0195f3e3851408dad433fecde92e7952025-02-03T01:32:51ZengWileyCase Reports in Surgery2090-69002090-69192013-01-01201310.1155/2013/695318695318Iatrogenic Sinistral Hypertension Complicating Screening ColonoscopyOliver J. Ziff0A. M. James Shapiro1Department of Surgery, University of Alberta, 2000 College Plaza, 8215 112th Street, Edmonton, AB, T6G 2C8, CanadaDepartment of Surgery, University of Alberta, 2000 College Plaza, 8215 112th Street, Edmonton, AB, T6G 2C8, CanadaColonoscopy is widely accepted as the gold-standard screening technique for detecting malignancies in the distal gastrointestinal tract in patients with symptoms suggestive of colon cancer. However, this procedure is not without risk, including colonic perforation. We report a patient who was managed conservatively after colonoscopy induced perforation. Eighteen months after appearing to make a full recovery, he presented with an upper gastrointestinal bleed. Oesophago-gastro-duodenoscopy (OGD) revealed large gastric fundal varices and computed tomography (CT) revealed splenic vein thrombosis. The ensuing left-sided (sinistral) hypertension explains the development of the fundal varices in the presence of normal liver function. At surgery, a persistent abscess cavity was identified and cultures from this site grew Streptococcus anginosus. Curative splenectomy was performed and the patient made a full recovery. We advocate more prompt operative intervention in selected cases of iatrogenic colonic perforation with primary repair to prevent late complications.http://dx.doi.org/10.1155/2013/695318 |
| spellingShingle | Oliver J. Ziff A. M. James Shapiro Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy Case Reports in Surgery |
| title | Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy |
| title_full | Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy |
| title_fullStr | Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy |
| title_full_unstemmed | Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy |
| title_short | Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy |
| title_sort | iatrogenic sinistral hypertension complicating screening colonoscopy |
| url | http://dx.doi.org/10.1155/2013/695318 |
| work_keys_str_mv | AT oliverjziff iatrogenicsinistralhypertensioncomplicatingscreeningcolonoscopy AT amjamesshapiro iatrogenicsinistralhypertensioncomplicatingscreeningcolonoscopy |