Successful endoscopic closure with an over-the-scope clip for sigmoid colon perforation due to bile duct stent migration

AbstractAn 86-year-old woman presented with a history of endoscopic papillary sphincterotomy for bile duct stones and diverticulitis. The patient was admitted as an emergency case of acute cholangitis due to choledocholithiasis, underwent endoscopic bile duct stenting, and was discharged with a plan for endoscopic lithotripsy. One month later, the patient was readmitted owing to abdominal pain. Abdominal computed tomography at admission showed that the bile duct stent had migrated to the sigmoid colon and the presence of a small amount of extraintestinal gas, suggesting a colonic perforation. Lower gastrointestinal endoscopy showed adhesions and intestinal stenosis in the sigmoid colon, probably after diverticulitis, and the bile duct stent that had perforated the same site. The stent was removed and endoscopic closure of the perforation was performed using an over-the-scope clip. Abdominal computed tomography 8 days after the closure showed no extraintestinal gas. The patient resumed eating and was discharged on the 14th day of admission. There was no recurrence of abdominal pain. Endoscopic closure of sigmoid colon perforation due to bile duct stent migration using an over-the-scope clip has not been reported thus far, and it may be a new treatment option in the future.

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Large iatrogenic sigmoid colon perforation treated with endoloop-assisted clip closure and over-the-scope clip: a case report

Endoscopy ◽

10.1055/a-1333-0620 ◽

2021 ◽

Author(s):

Salvatore Russo ◽

Giuseppe Grande ◽

Raffaele Manta ◽

Santi Mangiafico ◽

Helga Bertani ◽

...

Keyword(s):

Case Report ◽

Sigmoid Colon ◽

Colon Perforation ◽

Over The Scope Clip ◽

Sigmoid Colon Perforation ◽

Clip Closure

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Successful colonoscopic removal of a foreign body that caused sigmoid colon perforation: a case report

Journal of International Medical Research ◽

10.1177/0300060520982828 ◽

2021 ◽

Vol 49 (2) ◽

pp. 030006052098282

Author(s):

Zhenhua Ma ◽

Wujie Chen ◽

Ye Yang ◽

Zhenjie Xu ◽

Haitao Jiang ◽

...

Keyword(s):

Sigmoid Colon ◽

Large Bowel ◽

Bowel Perforation ◽

Colon Perforation ◽

Endoscopic Techniques ◽

Abdominal Emergency ◽

Large Bowel Perforation ◽

Endoscopic Closure ◽

Feasible Option ◽

Sigmoid Colon Perforation

Large bowel perforation is an acute abdominal emergency requiring rapid diagnosis for proper treatment. The high mortality rate associated with large bowel perforation underlines the importance of an accurate and timely diagnosis. Computed tomography is useful for diagnosis of ingested foreign bodies, and endoscopic repair using clips can be an effective treatment of colon perforations. We herein describe a 78-year-old man with sigmoid colon perforation caused by accidental swallowing of a jujube pit. The jujube pit had become stuck in the wall of the sigmoid colon and was successfully removed by colonoscopy, avoiding an aggressive surgery. As a result of developments in endoscopic techniques, endoscopic closure has become a feasible option for the management of intestinal perforation.

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A case of sigmoid colon perforation presenting with pneumomediastinum

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz359 ◽

2019 ◽

Vol 2019 (12) ◽

Author(s):

Yukihito Kuroda ◽

Katsuji Hisakura ◽

Yoshimasa Akashi ◽

Tsuyoshi Enomoto ◽

Tatsuya Oda

Keyword(s):

Computed Tomography ◽

Sigmoid Colon ◽

Gastrointestinal Endoscopy ◽

Abdominal Cavity ◽

Colon Perforation ◽

Upper Gastrointestinal Endoscopy ◽

Free Air ◽

Oral Steroids ◽

Sigmoid Colon Perforation ◽

Upper Gastrointestinal

Abstract A 62-year-old woman had developed polymyositis 12 years previously and had taken oral steroids. Chest and abdominal computed tomography showed pneumomediastinum and free air in the abdominal cavity. Although a colon perforation was suspected, the perforation site could not be identified on the image. In addition, a diagnosis of oesophageal rupture could not be excluded from the findings of pneumomediastinum. After general anaesthesia, an upper gastrointestinal endoscopy was performed before surgery. Because there was no obvious perforation in the oesophagus, a laparotomy approach was used. A perforation was found on the mesentery side of the sigmoid colon, and a perforation of the sigmoid colon’s diverticulum towards the mesentery was diagnosed. A Hartmann’s procedure was performed. Colon perforations are rarely associated with pneumomediastinum. Preoperative endoscopy is useful to help diagnose and determine the surgical procedure if an obvious perforation cannot be identified.

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Delayed Post-Barium Enema Sigmoid Colon Perforation Due to Squamous Cell Carcinoma Invasion from an Unknown Primary Source

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.44.78 ◽

2011 ◽

Vol 44 (1) ◽

pp. 78-83 ◽

Cited By ~ 1

Author(s):

Tomoki Yamano ◽

Chikao Yutani ◽

Isao Arai ◽

Toshiaki Takada

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Sigmoid Colon ◽

Barium Enema ◽

Squamous Cell ◽

Primary Source ◽

Colon Perforation ◽

Unknown Primary ◽

Sigmoid Colon Perforation

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Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

Journal of Clinical Imaging Science ◽

10.25259/jcis-17-2019 ◽

2019 ◽

Vol 9 ◽

pp. 23

Author(s):

Giulia Frauenfelder ◽

Annamaria Maraziti ◽

Vincenzo Ciccone ◽

Giuliano Maraziti ◽

Oliviero Caleo ◽

...

Keyword(s):

Computed Tomography ◽

Abdominal Pain ◽

Bile Duct ◽

Common Bile Duct ◽

Acute Abdominal Pain ◽

Imaging Modality ◽

Biliary Duct ◽

History Of ◽

The Common ◽

Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

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Sigmoid Colon Perforation Occurred in 12 years after Renal Transplantation

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.39.620 ◽

2006 ◽

Vol 39 (5) ◽

pp. 620-625 ◽

Cited By ~ 2

Author(s):

Hiroaki Takeshita ◽

Takashi Tsuji ◽

Terumitsu Sawai ◽

Shigekazu Hidaka ◽

Shinichi Shibazaki ◽

...

Keyword(s):

Renal Transplantation ◽

Sigmoid Colon ◽

Colon Perforation ◽

Sigmoid Colon Perforation

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Transmurally migrated gossypiboma rarely posing as surgical site infection: a case report and review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20204168 ◽

2020 ◽

Vol 7 (10) ◽

pp. 3500

Author(s):

Amrita Gaurav ◽

Juhi Mishra ◽

Om Kumari ◽

Kavita Khoiwal ◽

Farhanul Huda ◽

...

Keyword(s):

Caesarean Section ◽

Surgical Site Infection ◽

Sigmoid Colon ◽

Primary Repair ◽

Wound Dehiscence ◽

Colon Perforation ◽

Site Infection ◽

Surgical Sponge ◽

Ileal Loop ◽

Sigmoid Colon Perforation

The term gossypiboma is used to describe a retained surgical sponge or gauge after surgery. The clinical features range from being asymptomatic to frank bowel obstruction, perforation and peritonitis. Radiological modalities also do not provide a definite diagnosis. We report a case of a 30-year-old lady who presented to the emergency room with recurrent surgical site infection. She had a history of caesarean section 5 months ago. Following the caesarean section, she developed superficial wound dehiscence which was re-sutured. At the present facility, the lady underwent Computed tomography (CT) scan and was suspected to have a foreign body around the gut. She was planned for an exploratory laparotomy. Upon laparotomy, a large thick-walled ileal loop with some unusual intra luminal mass was found. Dense adhesions were present between the ileal loop and sigmoid colon. Adhesiolysis led to an iatrogenic sigmoid colon perforation, around 2 cm length. On incision over the ileal loop, surgical sponge was retrieved. Ileal loop was resected along with perforated site with end-to-end ileo-ileal anastomosis was done. Primary repair of sigmoid colon perforation was done. Patient was stable in postoperative period. Although rare, gossypiboma should be kept in mind as a differential diagnosis in postoperative cases presenting with recurrent surgical site infection.

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Early-onset sigmoid colon perforation during concurrent chemoradiation in a patient with cervical cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200403000-00030 ◽

2004 ◽

Vol 14 (2) ◽

pp. 381-383

Author(s):

H. Lin ◽

C.-L. Chang ◽

E.-Y. Huang ◽

C.-C. Changchien

Keyword(s):

Cervical Cancer ◽

Sigmoid Colon ◽

Concurrent Chemoradiotherapy ◽

Tissue Injury ◽

Gynecological Cancer ◽

Good Condition ◽

External Beam Radiation ◽

Colon Perforation ◽

Beam Radiation ◽

Sigmoid Colon Perforation

Radiation-induced colon perforation is a rare adverse effect caused by vascular and connective tissue injury to the rectosigmoid colon. It usually occurs a few months to years after radiotherapy for gynecological cancer. Herein, we present a patient who developed sigmoid colon perforation during concurrent chemoradiotherapy for cervical cancer. The patient was a 64-year-old clinical stage IIB woman who received concurrent chemoradiotherapy as a standard treatment. The chemotherapeutic protocol was cisplatin 50 mg/m2 and 5-fluorouracil 4000 mg, starting together with radiotherapy. After the completion of external beam radiation for 4500 cGy, the patient developed sigmoid colon perforation presenting with fecal peritoneum and sepsis. An emergency end ileostomy with resection of entire sigmoid colon was performed and the patient was discharged 3 months later in good condition. Clinicians must be highly suspicious of serious bowel perforation, even if the full dose of radiation has not been completed. Whether or not the chemotherapy was the trigger factor is in need of further clarification.

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