Kang Yeo Wool, Lee Jong Yoon, Lee Jong Hoon
Division of Gastroenterology, Department of Internal Medicine, Dong-A University Hospital, Busan, Korea.
Korean J Gastroenterol. 2020 Nov 25;76(5):246-250. doi: 10.4166/kjg.2020.124.
Colonoscopy is a safe and extremely popular diagnostic and therapeutic procedure. The most common complications are bleeding and perforation. Hemoperitoneum is a rare complication after a colonoscopy and is usually associated with splenic injury or solid organ pathology. This is potentially serious and can be life threatening. With the increasing number of colonoscopies performed, there has also been an increasing trend in reports of rare complications, such as pneumothorax, pneumomediastinum, appendicitis, small bowel perforation, septicemia, mesenteric tear, retroperitoneal abscess, and hemoperitoneum. This paper reports a unique case of hemoperitoneum after a recent colonoscopy without a splenic rupture or intra-abdominal abnormality, or external trauma. Most hemoperitoneum occurs within 48 hours after the inciting colonoscopy. In the present case, however, hemoperitoneum appeared 10 days after the colonoscopy. This case emphasizes that physicians should consider hemoperitoneum in a differential diagnosis of abdominal pain in patients after colonoscopy.
结肠镜检查是一种安全且极受欢迎的诊断和治疗方法。最常见的并发症是出血和穿孔。腹腔积血是结肠镜检查后罕见的并发症,通常与脾损伤或实体器官病变有关。这可能很严重,甚至危及生命。随着结肠镜检查数量的增加,诸如气胸、纵隔气肿、阑尾炎、小肠穿孔、败血症、肠系膜撕裂、腹膜后脓肿和腹腔积血等罕见并发症的报告也呈上升趋势。本文报告了一例近期结肠镜检查后发生腹腔积血的独特病例,该病例无脾破裂、腹腔内异常或外部创伤。大多数腹腔积血发生在引发结肠镜检查后的48小时内。然而,在本病例中,腹腔积血在结肠镜检查10天后出现。该病例强调,医生在对结肠镜检查后患者的腹痛进行鉴别诊断时应考虑腹腔积血。