An Unusual Case of Intraabdominal Abscess After a Colonoscopy With Polypectomy

Abstract

The use of colonoscopies in the screening of colorectal cancers has helped in the early detection and treatment of these cancers. Less than 0.5% of patients develop colonoscopy complications, mostly bleeding, and less frequently, perforations. There have been very few reported cases of micro-perforations following colonoscopies. We present a case of a 66-year-old female smoker who had undergone a screening colonoscopy for colorectal cancer with two polyps removed 3 weeks prior, who was brought to the hospital because of altered mental status and hypotension. A computed tomography (CT) scan of the abdomen and pelvis with contrast demonstrated intraabdominal abscess which was drained by interventional radiology. A culture of the pus grew Streptococcus constellatus, a pus-forming bacterium. She was treated with ceftriaxone and metronidazole for a total of 6 weeks, and a repeat CT of abdomen and pelvis demonstrated complete resolution. The only contributing factor to the formation of the intraabdominal abscess was a screening colonoscopy with polypectomy, which might have caused micro-perforations in the colon with the seeding of Streptococcus constellatus. The occurrence of intraabdominal abscess following a colonoscopy is very rare, and requires a high index of suspicion in patients who present with sepsis following colonoscopies.

Multiple Lung Cavity Lesions, Thoracic Wall Abscess and Vertebral Destruction Caused by Streptococcus constellatus Infection: A Case Report

“…Streptococcus constellatus was reportedly a pathogen in purulent infections including intracranial empyema, liver abscess, pleural effusion, head and neck infections. [12][13][14][15][16] Whereas, few to no studies have reported Streptococcus constellatus leading to multiple pulmonary cavity lesions and vertebral purulent infection. Streptococcus constellatus was considered causing pulmonary infections via aspiration, direct implantation, and hematogenous dissemination.…”

Rectus abdominis muscle abscess after performing colonoscopy—A case report

“…The mechanism is local mechanical trauma 3 . Intraperitoneal and retroperitoneal abscess formation are also described in a few case reports as a result of colonoscopy 4,5 . As far as we know, there is no report of Rectus Abdominis muscle abscess after colonoscopy.…”

“… 3 Intraperitoneal and retroperitoneal abscess formation are also described in a few case reports as a result of colonoscopy. 4 , 5 As far as we know, there is no report of Rectus Abdominis muscle abscess after colonoscopy. In this article, we want to present a case of rectus abdominis muscle abscess after a colonoscopy completed by applying abdominal pressure techniques.…”

Empyema caused by streptococcus constellatus in a patient infected with HIV: a case report and literature review

“…It is usually not considered a pathogen and may be underestimated. In recent years, there are gradually been reported that S. constellatus induces abscesses mainly in brain, mediastina, liver, bone and soft tissues [4][5][6][7][8][9] with the improvement of detection technology. However, there are few reported about HIV/AIDS combined with S. constellatus, although it's reported that this pathogen may cause invasive infections after entering sterile sites in the body, especially in patients with immunosuppression [10].…”