View source for Colonoscopy complications

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==Background==

*Over 85% of the serious colonoscopy complications are reported in patients undergoing colonoscopy with polypectomy (7-fold increase)<ref>Complications of colonoscopy. GASTROINTESTINAL ENDOSCOPY Volume 74, No. 4 : 2011</ref>


==Clinical Features==

*Hemorrhage
**Most common complication
**Caused by polypectomy, biopsy, mucosal lacerations, mesenteric or splenic tears
**[[Special:MyLanguage/Rectal bleeding|Rectal bleeding]] (if intraluminal)
**Intra-abdominal bleed (if mesenteric or [[Special:MyLanguage/splenic trauma|splenic trauma]])
*Perforation
*Post-polypectomy electrocoagulation syndrome
**peritoneal inflammation without frank perforation
**[[Special:MyLanguage/abdominal pain|abdominal pain]], [[Special:MyLanguage/fever|fever]], [[Special:MyLanguage/leukocytosis|leukocytosis]]
*[[Special:MyLanguage/Infection|Infection]]: [[Special:MyLanguage/bacteremia|bacteremia]], retroperitoneal abscess, [[Special:MyLanguage/appendicitis|appendicitis]]
*Colonic distension, precipitation of [[Special:MyLanguage/toxic megacolon|toxic megacolon]]
*[[Special:MyLanguage/Myocardial infarction|Myocardial infarction]], [[Special:MyLanguage/PE|PE]] (if off anticoagulation)
*Gas explosion
**methane (in flatus) + electrocautery → BOOM!


==Differential Diagnosis==

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{{Lower GI bleeding DDX}}
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{{Abdominal Pain DDX Diffuse}}
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==Evaluation==

*CBC
*Coags, T&S if bleeding
*[[Special:MyLanguage/CXR|CXR]] for free air if concern for perforation
*CT abdomen/pelvis (if presentation concerning for intra-abdominal bleed, infection, or perforation)


==Management==

*[[Special:MyLanguage/PRBC|PRBC]] transfusion, reverse coagulopathy if significant bleed
*Surgery (or IR) consult for possible laparotomy if concern for intra-abdominal bleed, perforation, or [[Special:MyLanguage/abscess|abscess]] 
*Antibiotics if concern for perforation or infection
**See [[Special:MyLanguage/peritonitis|peritonitis]]


==Disposition==


==See Also==

*[[Special:MyLanguage/Post-surgical complications|Post-surgical complications]]


==External Links==


==References==

<references/>

[[Category:Surgery]] [[Category:GI]]
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