Zhuang Zhuang-Feng, Ye Zhen-Hao, Zhong Zi-Shao, He Gui-Hua, Wang Jing, Huang Sui-Ping
Department of Gastroenterology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, China.
Ann Palliat Med. 2020 Mar;9(2):488-492. doi: 10.21037/apm.2020.01.01. Epub 2020 Feb 25.
Post-polypectomy syndrome (PPS) results from electrocoagulation injury to the bowel wall that induces a transmural burn and localized peritonitis. It has a good prognosis; however, there are exceptions when complications are observed. We here report a case of a 50-year-old man who developed lumbosacral pain and high fever with chills four days after colonoscopy, during which polypectomy was performed by endoscopic mucosal resection (EMR) and argon plasma coagulation (APC). Both the plain abdominal film and abdominal CT scan showed no free air, and lumbar CT showed no apparent lesions, which satisfied the diagnosis of PPS. However, the patient was in a critical condition as he developed septic shock caused by bacteremia. Following active treatment, the patient's condition rapidly improved. Therefore, we suggest that clinicians should consider the severity of PPS with sepsis and colon transmural burn. Patients with a diagnosis of PPS should be admitted to the hospital for observation and treatment to avoid adverse consequences.
息肉切除术后综合征（PPS）是由肠壁电凝损伤引起的，这种损伤会导致透壁烧伤和局限性腹膜炎。其预后良好；然而，观察到并发症时则为例外情况。我们在此报告一例50岁男性病例，该患者在结肠镜检查后四天出现腰骶部疼痛和高热伴寒战，结肠镜检查期间通过内镜黏膜切除术（EMR）和氩离子凝固术（APC）进行了息肉切除。腹部平片和腹部CT扫描均未显示游离气体，腰椎CT也未显示明显病变，这符合PPS的诊断。然而，患者因菌血症引发感染性休克，病情危急。经过积极治疗，患者病情迅速好转。因此，我们建议临床医生应考虑PPS合并脓毒症及结肠透壁烧伤的严重程度。诊断为PPS的患者应住院观察和治疗，以避免不良后果。
