It may be classified as acute primary, secondary or recurrent according to its cause and duration. Ībdominal compartment syndrome (ACS) refers to organ dysfunction that may occur as a result of increased intra-abdominal pressure (IAP). It is well established that therapeutic colonoscopies are associated with a higher incidence of perforation than diagnostic ones. The diagnosis is often suspected after the visualization of extra-intestinal tissue. In diagnostic procedures, perforations often result from the pressure on the colonic wall, especially in ones noted to be a 'difficult procedure' by the endoscopist. The frequency of perforation is estimated to be 0.03% to 0.9% for diagnostic colonoscopy and 0.15% to 2% for therapeutic colonoscopy. It should be kept in mind during colonoscopy, especially considering its simple salvage treatment.Ĭolonic perforation due to colonoscopy rarely occurs but still remains a major complication with a high rate of morbidity and mortality and often needs surgical management.
ConclusionĪcute abdominal compartment syndrome is a rare disease that may occasionally occur after a colonoscopic perforation.
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Our patient remains alive and free of disease three years later. An emergency laparotomy with anterior resection, including the perforated sigmoid colon, was then performed followed by immediate anastomosis. Our patient was treated by needle decompression after the failure of cardiopulmonary resuscitation. We report a case of acute abdominal compartment syndrome after perforation of the bowel during a colonoscopy in a 60-year-old North African man with rectal cancer, resulting in respiratory distress, cyanosis and cardiac arrest. It can be responsible for acute abdominal compartment syndrome, a potentially lethal complex pathological state in which an acute increase in intra-abdominal pressure may provoke the failure of several organ systems. A perforation occurring during colonoscopy is an extremely rare complication that may be difficult to diagnose.
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