Massive retroperitoneal hematoma following colonoscopy

Abstract

Rationale:Colonoscopy has been used for screening and treatment of diseases worldwide. Endoscopic mucosal resection (EMR) has many major complications such as colon perforation and bleeding. However, cases of minor complications have also been reported. Here, we present a case of massive retroperitoneal hematoma, as a minor complication, after colonoscopy.Patient concerns:A 57-year-old man was admitted to our hospital because of abdominal pain. He had no past medical history relating to his present condition, and he received EMR at another hospital 11 days before his admission. Dynamic computed tomography (CT) was performed, which showed a massive retroperitoneal hematoma near the third portion of the duodenum.Diagnosis:The patient had a superior mesenteric vein injury after the colonoscopy.Outcomes:The patient did not complain of nausea or vomiting and was discharged after 43 days.Lessons:Although massive retroperitoneal hematoma is a minor complication after colonoscopy, it can be life threatening; thus, we need to know more about this complication. Dynamic CT may be useful in detecting whether the bleeding occurs from the artery or not.

Intramural Hematoma and Retroperitoneal Hematoma Following a Routine Colonoscopy: An Uncommon Complication of a Common Procedure

“…The risk of these AEs is reported predominantly in elderly population, patients with comorbidities, and those who undergo polypectomy and endoscopic mucosal resection [ 2 , 3 ]. Potentially life-threatening AEs like pericolonic hematoma and massive retroperitoneal hematoma may also occur, and there is scant literature published on these rarer AEs [ 4 , 5 ].…”

“…In a 2016 evidence synthesis report by Agency of Healthcare Research and Policy, the authors reported the overall rate of major bleeding of 0.8 per 1,000 procedures (n Z 3,347,101, 95% CI, 0.5–1.4) and the perforation rate of 0.4 per 1,000 procedures (95% CI, 0.2–0.5) for screening colonoscopy [ 3 ]. Globally, most studies of AEs of this procedure are conducted in the West and relatively few studies have been conducted in the East [ 4 , 6 ].…”

“…The diagnostic imaging widely used is CT scan of abdomen. Dynamic CT or 3-dimensional CT scan over routinely performed CT is found to be useful in early detection [ 4 ]. Medical management of AEs like bleeding/intra-abdominal hematoma formation in the patient described above involves hemodynamic stability, bowel rest, and symptomatic management [ 5 ].…”