Unexpected Delayed Colon Perforation after the Endoscopic Submucosal Dissection with Snaring of a Laterally Spreading Tumor.

Author: Young Bo KO ¹ ; Jeong Mi LEE ; Wan Soo KIM ; Min Seob KWAK ; Ji Wan LEE ; Dong Yeol SHIN ; Dong Hoon YANG ; Jeong Sik BYEON
Author Information

1. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jsbyeon@amc.seoul.kr
Publication Type:Case Report
Keywords: Delayed perforation; Risk factor; Mechanism; Endoscopic submucosal dissection
MeSH: Colon*; Colonoscopy; Fibrosis; Humans; Risk Factors; SNARE Proteins*
From:Clinical Endoscopy 2015;48(6):570-575
CountryRepublic of Korea
Language:English
Abstract: Colonic perforation may occur as a complication of diagnostic and therapeutic colonoscopy. The risk factors for perforation after colorectal endoscopic submucosal dissection (ESD) include an inexperienced endoscopist, a large tumor size, and submucosal fibrosis. The mechanisms of perforation include unintended endoscopic resection/dissection and severe thermal injury. Here, we report a case of colon perforation that occurred after ESD with snaring of a laterally spreading tumor. The perforation was completely unexpected because there were no colorectal ESD-associated risk factors for perforation, deep dissection, or severe coagulation injury in our patient.