Presentation
Several hours post colonoscopy, with RLQ abdominal pain.
Patient Data
Marked circumferential mural thickening and submucosal edema measuring up to 10mm and involving the cecum and ascending colon over a combined distance of approximately 14cm.
Moderate surrounding free fluid and inflammatory stranding, however there is no evidence of free gas. A few small adjacent lymph nodes appear unremarkable. No pneumatosis. No evidence of arterial occlusion. Transverse colon, descending colon and sigmoid have uniformly thin walls. Normal appearance of the terminal ileum. No small bowel obstruction.
Case Discussion
On review of procedure notes, patient had a polyp removed from the ascending colon with a hot snare. Patient was observed as an inpatient for several days prior to discharge.
Post-polypectomy coagulation syndrome (PPCS, post-polypectomy electrocoagulation syndrome) is an uncommon complication that can occur in colonoscopies if electrocoagulation is used (for example, to remove a polyp). The colon can appear markedly inflamed, but there will be no evidence of perforation.
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