Asymptomatic Isolated Right Sided Pneumothorax After Screening Colonoscopy with Polypectomy

Keisha P Bonner, Alexius Ramcharan, MD

Harlem Hospital Center

Colonic perforation following diagnostic colonoscopy has been reported in the literature. However, no case of asymptomatic colonic perforation with isolated right pneumothorax and the absence of pneumomediastinum following colonoscopy has been described. This poster presentation is aimed at presenting this unique case that followed screening colonoscopy with snare polypectomy.

The case being discussed is that of a 50 year old woman who presented for screening colonoscopy. At this time she was noted to have a polyp in the sigmoid colon. This was excised using snare polypectomy and during the procedure she was noted to have a perforation where the polypectomy was done. The perforated area was clipped at this time. She remained asymptomatic and hemodynamically stable for the remainder of the procedure and immediately after the procedure. She had a follow up Computed axial tomography scan immediately subsequent to the procedure, in light of the visualized perforation. This revealed a large right- sided pneumothorax and free intra peritoneal air. She then had a right thoracostomy tube placed and she was treated with close observation in the Intensive Care Unit, antibiotics and nil per os. The patient was discharged five days subsequently with no interval complications.

This poster presentation therefore discusses the pathophysiological basis behind this presentation and discusses the need for awareness of this complication in asymptomatic individuals and that follow up imaging prior to discharge may be warranted in this patient population.

Session: Poster Presentation

Program Number: P592