Colon mucosal injury caused by water jet malfunction during a screening colonoscopy: A case report

BACKGROUND: Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation, bleeding, infection, and post-polypectomy syndrome. True device related adverse events are rarely reported in the literature. CASE SUMMARY: We report a case of a 51-year-old patient without past medical history who presented for her first screening colonoscopy. The patient was thought to have friable mucosa in the cecum and oozed upon water irrigation during screening colonoscopy. It was later identified that the colonoscope used during the index procedure had malfunctioned and produced a pin-point water jet which damaged the colon mucosa of cecum. The maintenance service identified a piece of rubber fragment lodged in the instrument component at the tip of the scope, resulting in high pressure water jet. Repeat colonoscopy with a functioning colonoscope confirmed normal colon mucosa without friability. CONCLUSION: This is the first report of mucosa injury from a colonoscope water jet malfunction. Endoscopists should recognize the potential for endoscopic malfunction.