Colonic Diseases ; diagnosis ; etiology ; surgery ; Female ; Humans ; Infant, Newborn ; Intestinal Perforation ; diagnosis ; etiology ; surgery ; Male

Colon, Ascending ; injuries ; Foreign Bodies ; complications ; Humans ; Intestinal Perforation ; diagnosis ; etiology ; surgery ; Male ; Middle Aged ; Seafood

No abstract availble.
Adult ; Crohn Disease/*complications ; Humans ; Intestinal Fistula/*diagnosis/*etiology ; Intestinal Perforation/*diagnosis/*etiology ; Male ; Tomography, X-Ray Computed ; Urinary Bladder/radiography

Cytomegalovirus (CMV) infection is usually subclinical in immunocompetent individuals, however it can be life threatening in an elderly immunocompetent individual. We report a case of CMV enteritis causing ileal perforation in a physically active elderly man. An 88-year-old healthy man presented with abdominal pain and diarrhea. After initial conservative treatment, emergency laparotomy was performed for ileal perforation. The diagnosis of CMV enteritis was based on histological findings revealing many large cells with CMV inclusion bodies in the surgical specimen. In elderly individuals, even though they are immunocompetent, CMV enteritis may result in major complications such as bowel perforation, and it should be included in the differential diagnosis of diarrhea if it is resistant to conventional treatment.
Aged, 80 and over ; Cytomegalovirus Infections/*complications/diagnosis ; Enteritis/*complications/diagnosis ; Humans ; Immunocompetence ; Intestinal Perforation/*etiology ; Male ; Tomography, X-Ray Computed

We report a case of tension pneumothorax after an endoscopic sphincterotomy. A 78-yr-old woman presented with progressing dyspnea. She had undergone an endoscopic retrograde cholangiopancreatogram three days before due to acute cholecystitis. She underwent endoscopic sphincterotomy for stone extraction, but the procedure failed. On arrival to our hospital, she complained about severe dyspnea and she had subcutaneous emphysema. A computed tomogram scan revealed severe subcutaneous emphysema, right-side tension pneumothorax, and pneumoretroperitoneum. Contrast media injected through a transnasal biliary drainage catheter spilled from the second portion of the duodenum. A second abdominal computed tomogram showed multiple air densities in the retroperitoneum and peritoneal cavity, which were consistent with panperitonitis. We recommended an emergent laparotomic exploration, but the patient's guardians refused. She died eventually due to septic shock. Endoscopic retrograde cholangiopancreatogram is a popular procedure for biliary and pancreatic diseases, but it can cause severe complications such as intestinal perforation. Besides perforations, air can spread through the abdominal cavity, retroperitoneum, mediastinum, and the neck soft tissue, eventually causing pneumothorax. Early recognition and appropriate management is crucial to an optimal output of gastrointestinal perforation and pneumothorax.
Acute Disease ; Aged ; Cholangiopancreatography, Endoscopic Retrograde/*adverse effects ; Cholecystitis/diagnosis ; Female ; Humans ; Intestinal Perforation/etiology ; Pneumothorax/*diagnosis/etiology ; Retropneumoperitoneum/*diagnosis/etiology ; Sphincterotomy, Endoscopic ; Tomography, X-Ray Computed

Jejunal infarction as a complication of acute pancreatitis is not common and can not be well recognized. This jejunal infarction usually arises from the venous thrombosis rather than arterial thrombosis. Jejunal infarction results in bowel perforation or stenosis according to its extension of injury and progression rate. Pathologic findings of the involved jejunum show a segmental transmural infarction and mesenteric venous thrombotic occlusions. Early diagnosis should be made for better prognosis. We report a patient with jejunal infarction resulting perforation due to acute pancreatitis, in which the initial presenting symptoms were hematemesis and abdominal distention.
Acute Disease ; Adult ; English Abstract ; Humans ; Infarction/diagnosis/*etiology ; Intestinal Perforation/diagnosis/*etiology ; Jejunal Diseases/diagnosis/*etiology ; Jejunum/*blood supply ; Male ; Pancreatitis/*complications ; Rupture, Spontaneous

Crohn's disease is characterized by its chronic course and transmural inflammation of gastrointestinal tract. The accompanying fibrous reaction and adhesion to adjacent viscera appears to limit the complication of free perforation. The true incidence of free bowel perforation is difficult to assess, however, the anticipated occurrence rate is 1-2% during the course of illness. Moreover, portal venous gas is also an uncommon event in the natural history of Crohn's disease. Portal venous gas occurs when intraluminal gas from the gastrointestinal tract or gas-forming bacteria enters the portal venous circulation. The finding of portal venous gas associated with Crohn's disease does not always mandate surgical intervention. We experienced a case of Crohn's disease presenting with free perforation and portal venous gas. The literatures on the cases with perforation and portal venous gas associated with Crohn's disease were reviewed.
Adult ; Colonoscopy ; Crohn Disease/complications/drug therapy/*pathology ; Diagnosis, Differential ; Embolism, Air/*diagnosis/etiology ; Humans ; Intestinal Perforation/*diagnosis/etiology ; Male ; *Portal Vein ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Colonoscopy is the principal method for diagnosis, treatment, and follow up of colorectal disease. The study aimed to assess the incidence, clinical features, and management of colonoscopic perforations at a local general hospital. METHODS: A retrospective review of patient record was performed for all patients with iatrogenic colonic perforation after sigmoidoscopy and colonoscopy between 1997 and 2007. RESULTS: In the 10-year period, 16,388 colonoscopic and sigmoidscopic procedure were performed. All 10 cases of procedure related colonic perforation were developed. Perforation occurred in 9 cases during therapeutic procedure; 5 cases due to polypectomy and 4 cases due to endoscopic submucosal dissection. Perforation occurred in one case during diagnostic procedure. CONCLUSIONS: Therapeutic procedure is a clear risk factor of colonic perforation. When colonic perforation occurs, we should be able to make early diagnosis. Early diagnosis can lead to a good treatment and can produce good prognosis with short hospital days.
Colonic Diseases/diagnosis/epidemiology/*etiology ; Colonoscopy/*adverse effects ; Humans ; *Iatrogenic Disease/epidemiology ; Incidence ; Intestinal Perforation/*diagnosis/epidemiology/*etiology ; Prognosis ; Retrospective Studies ; Risk Factors ; Sigmoidoscopy/adverse effects

No abstract available.
Aged ; Colonoscopy ; Enema/*adverse effects ; Humans ; Intestinal Perforation/*diagnosis/etiology ; Male ; Rectal Diseases/*diagnosis/diagnostic imaging/etiology ; Tomography, X-Ray Computed

Perforation of the colon occurs in 0.2 to 2% of all colonoscopic examinations. The most common sites of perforation are rectosigmoid junction and cecal area. Colonic perforation, leading to tension pneumoperitoneum in most cases, may be caused by direct trauma or pressurized air. It should be suspected in patients with hypotension, tachycardia and tachypnea during or after the colonoscopy. An 83-year-old woman was admitted due to pulmonary embolism and left cerebellar infarction. Colonoscopy was performed due to bloody diarrhea. She was diagnosed as cytomegalovirus (CMV) colitis. One week after the colonoscopy, colon perforation was incidentally found on ascending colon, and tension pneumoperitoneum occurred immediately after the procedure. The perforated site was primarily closed and the patient discharged 20 days later. Herein, we report a case of tension pneumoperitoneum following colonoscopy in a patient with CMV colitis.
Aged, 80 and over ; Colitis/*diagnosis/virology ; Colon/*injuries ; Colonoscopy/*adverse effects ; Cytomegalovirus Infections/*diagnosis ; Female ; Humans ; Intestinal Perforation/*etiology ; Pneumoperitoneum/*etiology