An unusual case of severe colitis after colonoscopy

Singh-Ranger, Gurpreet; Halls, Andrew; Grundy, A.; Kumar, Devinder

doi:10.1016/j.crohns.2011.02.015

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Patients with IBS-C have a prolonged transit time, which can increase the colon wall exposure with the colon-cleansing agent, resulting in even more severe damage. According to a case report, inadequate removal of glutaraldehyde during a colonoscopy had a similar effect [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Colitis Induced by Colon-Cleansing Agent

Mehershahi

Ghazanfar

Ashraf

et al. 2021

Case Rep Gastroenterol

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Constipation is one of the most common functional gastrointestinal disorders and affects 20% of the general population. Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract that affects the large intestine and is characterized by chronic abdominal pain and altered bowel habits. We report a case of a 35-year-old African American man with a past medical history of IBS who presented to the clinic with a chief complaint of abdominal pain and bloody diarrhea for 1 week. The patient stated that he used a colon-cleansing agent because of persistent constipation. Computed tomography scan of the patient’s abdomen and pelvis with contrast was performed which showed diffuse contiguous segmental mural thickening and nodularity seen along the distal transverse, descending, and sigmoid colon. Colonoscopy showed moderate diffuse inflammation characterized by altered vascularity, erythema, and granularity from the rectum to the descending colon, and localized mild inflammation characterized by erythema was found at the ileocecal valve. The patient’s clinical condition improved with symptomatic management over 10 days. Patients with IBS should be advised to restrain from using a colon-cleansing agent without advice from their primary doctor as it can lead to various complications.

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Section: Discussionmentioning

confidence: 99%

Colitis Induced by Colon-Cleansing Agent

Mehershahi

Ghazanfar

Ashraf

et al. 2021

Case Rep Gastroenterol

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Ischemic Colitis after Colonoscopy with Bisacodyl Bowel Preparation: A Report of Two Cases

Shamatutu

Chahal

Tai

et al. 2020

Case Reports in Gastrointestinal Medicine

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Background. Colonoscopy is widely used for the diagnosis and management of colorectal disease and requires adequate bowel preparation. Ischemic colitis is a form of intestinal ischemia that presents with abdominal pain, diarrhea, and hematochezia. Risk factors include advanced age, cardiovascular disease, and diabetes. Both colonoscopy and bisacodyl bowel preparation have been described as rare causes of ischemic colitis with less than 35 cases collectively in the literature. Our review found that of these cases, there exists significant heterogeneity within individual patient characteristics. The majority of the cases are managed conservatively without complications or sequela. Due to the risk of ischemic colitis, the FDA has withdrawn bisacodyl bowel preparations from use in the USA. Bisacodyl bowel preparations are still used in Canada. Cases. Here, we present two cases of ischemic colitis in previously healthy women aged 57 and 69 who underwent screening colonoscopy using bisacodyl bowel preparation. Both were treated conservatively without complications. Conclusion. Thus far, there has been one documented case of ischemic colitis following colonoscopy with bisacodyl bowel preparation; here, we present two additional cases with one case occurring without the presence of known risk factors for ischemic colitis. Our literature review finds that there is limited evidence surrounding bisacodyl as a causative agent of ischemic colitis. Cases often contain confounding variables such as the presence of known risk factors for ischemic colitis. Our report aims to highlight the need for a more comprehensive analysis evaluating the safety of bowel preparations as well as increasing the clinical awareness surrounding the rare risk of colonoscopy-induced ischemic colitis.

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Transmural Colonic Infarction after Routine Colonoscopy in a Young Patient without Risk Factors

Zizzo

Ruiz

Ugoletti

et al. 2016

Case Rep Gastroenterol

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Colonoscopy is one of the most widely used procedures in medical practice for the diagnosis and treatment of many benign and malignant diseases of the colorectal tract. Colonscopy has become the reference procedure for screening and surveillance of colorectal cancer. The overall rate of adverse events is estimated to be about 2.8 per 1,000 procedures, while complications requiring hospitalization are about 1.9 per 1,000 colonoscopies. Mortality from all causes and colonoscopy-specific mortality are estimated to be 0.07 and 0.007%, respectively. An exceptional fearsome postcolonoscopy complication is colon ischemia (CI); only few cases have been reported worldwide. We present the case of a 43-year-old woman who presented to the emergency department complaining of abdominal pain; fever and rectal bleeding appeared 12 h after a voluntary ‘screening’ colonoscopy. She had no risk factors for CI. Her laboratory tests showed alterations in inflammatory markers and a computed tomography scan showed a circumferential thickening in the left colon and free fluid in the abdomen. After 12 h of observation and conservative therapy, the clinical state of the patient worsened with the rising of signs of peritonitis. Laparoscopy showed that colon infarction extended from the distal third of the transverse colon to the proximal rectum. Laparotomy, resection of the pathological colon and terminal colostomy were performed. The specimen examined confirmed an extended ischemic colitis and transmural infarction on the antimesocolic side, in the absence of a vasculitis. The patient underwent recanalization after 8 months. CI after colonoscopy is a rare and alarming complication that must be known and taken into account in the differential diagnosis of symptomatic cases after colonoscopy, particularly in patients with known risk factors. The diagnosis is mainly based on clinical data, imaging and especially endoscopy. Treatment is almost always conservative but, in some cases in which the pathological process appears irreversible, surgery becomes mandatory.

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An unusual case of severe colitis after colonoscopy

Cited by 3 publications

References 7 publications

Colitis Induced by Colon-Cleansing Agent

Colitis Induced by Colon-Cleansing Agent

Ischemic Colitis after Colonoscopy with Bisacodyl Bowel Preparation: A Report of Two Cases

Transmural Colonic Infarction after Routine Colonoscopy in a Young Patient without Risk Factors

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