Korean J Gastroenterol.  2014 May;63(5):313-315. 10.4166/kjg.2014.63.5.313.

Mesocolon Laceration Following Colonoscopy

• Choi YJ
• Park JS
• Kim GE
• Han JY
• Nah SY
• Bang BW

• KMID: 2155330
• DOI: http://doi.org/10.4166/kjg.2014.63.5.313

Abstract

Colonoscopic examination is a safe procedure, however, unexpected complications can sometimes occur. Bleeding and perforation of the colon have been reported as the most common complications. Hemoperitoneum after colonoscopy is an unusual complication, but it may be catastrophic. We report on a 20-year-old man who experienced left low quadrant pain after undergoing colonoscopy. Hemoperitoneum was diagnosed using abdominal CT. A laparoscopic exploration was urgently performed, revealing a lacerated mesocolon of the descending colon. Bleeding of the injured site was controlled without complication. The patient recovered fully without signs of recurrent bleeding. This report implies that if the patient has persistent abdominal pain after undergoing colonoscopy, we should consider hemoperitoneum as one of the causes. To the best of our knowledge, no case of isolated laceration of the mesocolon of the descending colon after colonoscopy has been reported.

Keyword

Mesocolon; Colonoscopy; Hemoperitoneum

MeSH Terms

Colonoscopy/adverse effects
Hemorrhage/etiology
Humans
Lacerations/*diagnosis/radiography
Laparoscopy
Male
Mesocolon/blood supply
Pneumoperitoneum/radiography
Tomography, X-Ray Computed
Young Adult

Figure

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  Fig. 1. Plain chest X-ray showed the absence of pneumoperitoneum.

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  Fig. 2. Abdominal CT showed hyperattenuated fluid collections (Hounsfield unit: 40–60) in the anterior aspect of the sigmoid colon of the pelvic cavity, both paracolic gutters and right subhepatic space, suggesting intraperitoneal hemorrhage (arrow: A, axial image; B, reformatted coronal image).

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  Fig. 3. Laparoscopic finding showed a moderate amount of blood in the pelvic cavity.

Reference

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