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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...

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Autores principales: Katano, Kaoru, Furutani, Yuichiro, Hiranuma, Chikashi, Hattori, Masakazu, Doden, Kenji, Hashidume, Yasuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
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.
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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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