Mu Tong, Feng Hua
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China.
World J Clin Cases. 2022 Feb 26;10(6):2030-2035. doi: 10.12998/wjcc.v10.i6.2030.
Colonoscopy is essential for the diagnosis of intestinal Behcet's disease (BD), which is characterized by a typical oval-shaped ulcer in the ileocecal region. However, potential risks of colonoscopy have rarely been reported.
Herein, we describe a patient with intestinal BD who presented with decreased oxygen saturation and shortness of breath during a diagnostic colonoscopy. Bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum and subcutaneous emphysema of the neck, chest, abdomen, back and scrotum were confirmed by computed tomography scan. The sudden change in condition was considered to be associated with iatrogenic bowel perforation. After receiving closed thoracic drainage and conservative therapy, the patient was discharged in stable condition.
Endoscopists should be aware of the risks of colonoscopy in patients with intestinal BD and the possibility of pneumothorax associated with intestinal perforation and make adequate preparations before colonoscopy.
结肠镜检查对于诊断肠道白塞病(BD)至关重要,肠道白塞病的特征是在回盲部有典型的椭圆形溃疡。然而,结肠镜检查的潜在风险鲜有报道。
在此,我们描述一名肠道BD患者,其在诊断性结肠镜检查期间出现氧饱和度下降和呼吸急促。计算机断层扫描证实存在双侧气胸、纵隔气肿、气腹、腹膜后气肿以及颈部、胸部、腹部、背部和阴囊的皮下气肿。病情的突然变化被认为与医源性肠穿孔有关。在接受闭式胸腔引流和保守治疗后,患者病情稳定出院。
内镜医师应意识到肠道BD患者进行结肠镜检查的风险以及与肠穿孔相关的气胸可能性,并在结肠镜检查前做好充分准备。