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Bowel perforation during enema examination through a colostomy without leakage of contrast agent: A case report
INTRODUCTION: Enema examination is considered safe, but in rare cases, complications may result. Here, we report a rare case of iatrogenic bowel perforation during enema examination through a colostomy without leakage of contrast agent. PRESENTATION OF CASE: A 36-year-old man who had undergone a sig...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610033/ https://www.ncbi.nlm.nih.gov/pubmed/33137669 http://dx.doi.org/10.1016/j.ijscr.2020.10.101 |
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author | Katano, Kaoru Furutani, Yuichiro Hiranuma, Chikashi Hattori, Masakazu Doden, Kenji Hashidume, Yasuo |
author_facet | Katano, Kaoru Furutani, Yuichiro Hiranuma, Chikashi Hattori, Masakazu Doden, Kenji Hashidume, Yasuo |
author_sort | Katano, Kaoru |
collection | PubMed |
description | INTRODUCTION: Enema examination is considered safe, but in rare cases, complications may result. Here, we report a rare case of iatrogenic bowel perforation during enema examination through a colostomy without leakage of contrast agent. PRESENTATION OF CASE: A 36-year-old man who had undergone a sigmoid loop colostomy was diagnosed with ulcerative colitis. A bowel enema through a colostomy was performed by nurses and radiological technologists. During the procedure, a balloon catheter was inserted into the proximal lumen of the colostomy, and the balloon was inflated. The patient developed severe abdominal pain a few minutes following withdrawal of the catheter. Computed tomography showed intraperitoneal free air, although contrast agent leakage into the intraperitoneal cavity was not observed. The patient underwent emergency laparotomy. Intraoperatively, there was a 3-cm bowel perforation just inside the colostomy where the inflated balloon was pressing. DISCUSSION: The perforation site may have been sealed by the inflated balloon during the enema examination. In addition, the patient maintained a supine position during and after the examination. This led to contrast agent accumulating on the dorsal side and not leaking out from the perforation site after the balloon was deflated. CONCLUSION: Iatrogenic bowel perforation can occur without leakage of contrast agent during enema examination through a colostomy, and the examination should be performed under the supervision of an attending doctor. In the case of an enema examination through a colostomy, clinicians must be aware of the possibility of bowel perforation even if leakage of contrast agent is not observed. |
format | Online Article Text |
id | pubmed-7610033 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-76100332020-11-06 Bowel perforation during enema examination through a colostomy without leakage of contrast agent: A case report Katano, Kaoru Furutani, Yuichiro Hiranuma, Chikashi Hattori, Masakazu Doden, Kenji Hashidume, Yasuo Int J Surg Case Rep Case Report INTRODUCTION: Enema examination is considered safe, but in rare cases, complications may result. Here, we report a rare case of iatrogenic bowel perforation during enema examination through a colostomy without leakage of contrast agent. PRESENTATION OF CASE: A 36-year-old man who had undergone a sigmoid loop colostomy was diagnosed with ulcerative colitis. A bowel enema through a colostomy was performed by nurses and radiological technologists. During the procedure, a balloon catheter was inserted into the proximal lumen of the colostomy, and the balloon was inflated. The patient developed severe abdominal pain a few minutes following withdrawal of the catheter. Computed tomography showed intraperitoneal free air, although contrast agent leakage into the intraperitoneal cavity was not observed. The patient underwent emergency laparotomy. Intraoperatively, there was a 3-cm bowel perforation just inside the colostomy where the inflated balloon was pressing. DISCUSSION: The perforation site may have been sealed by the inflated balloon during the enema examination. In addition, the patient maintained a supine position during and after the examination. This led to contrast agent accumulating on the dorsal side and not leaking out from the perforation site after the balloon was deflated. CONCLUSION: Iatrogenic bowel perforation can occur without leakage of contrast agent during enema examination through a colostomy, and the examination should be performed under the supervision of an attending doctor. In the case of an enema examination through a colostomy, clinicians must be aware of the possibility of bowel perforation even if leakage of contrast agent is not observed. Elsevier 2020-10-24 /pmc/articles/PMC7610033/ /pubmed/33137669 http://dx.doi.org/10.1016/j.ijscr.2020.10.101 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Katano, Kaoru Furutani, Yuichiro Hiranuma, Chikashi Hattori, Masakazu Doden, Kenji Hashidume, Yasuo Bowel perforation during enema examination through a colostomy without leakage of contrast agent: A case report |
title | Bowel perforation during enema examination through a colostomy without leakage of contrast agent: A case report |
title_full | Bowel perforation during enema examination through a colostomy without leakage of contrast agent: A case report |
title_fullStr | Bowel perforation during enema examination through a colostomy without leakage of contrast agent: A case report |
title_full_unstemmed | Bowel perforation during enema examination through a colostomy without leakage of contrast agent: A case report |
title_short | Bowel perforation during enema examination through a colostomy without leakage of contrast agent: A case report |
title_sort | bowel perforation during enema examination through a colostomy without leakage of contrast agent: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610033/ https://www.ncbi.nlm.nih.gov/pubmed/33137669 http://dx.doi.org/10.1016/j.ijscr.2020.10.101 |
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