Endoscopic repair of a colonic perforation following polypectomy using an endoclip: CASE PRESENTATION (Part 1)
Polypectomy was carried out, but unfortunately the patient experienced immediate pain. It became apparent that the patient had suffered a perforation of colon, with an obvious pneumoperitoneum and distension of her abdomen along with protrusion of her umbilical hernia. Endoscopically, one could see the peritoneal contents. The defect measured at least 5 to 6 mm. The cecal wall was noted to be thin. We decided to try this novel approach of an endoclip application to approximate the colonic defect in this high risk patient.
Mucosa to mucosa approximation was achieved with placement of only two endo-clips (Figure 1), using an HX-600-135 reloadable clip (Olympus America Inc, USA). Following the repair, colonic gas was suctioned.
In addition, approximately 50 mL of intravenous x-ray contrast dye was placed at the repair site using an endoscopic retrograde cholangiopancreatography canula, to detect ongoing leakage by x-ray. Because the patient was experiencing pain, most of the pneumoperitoneum was taken out with a 20-gauge intravenous catheter through the umbilicus. Spend less money now – buy cipro online for your efficient drug to cost less.
Figure 1) Repair of colonic perforation with placement of two endo-clips