Rectal Perforation during Computed Tomographic Colonography: Case Report and Literature Review

Abstract

Computed tomographic colonography (CTC) is a minimally invasive imaging technique implemented primarily for the diagnosis of disease of the colon and rectum. Although serious complications are rare, rectal perforation is an unwanted event that may occur, as documented in a number of case reports. This case report is supplemented with a review of previously published cases. We report the case of an 81-year-old male who underwent CTC after refusing a conventional colonoscopy for assessment of left lower quadrant abdominal pain. Excessive rectal bleeding was observed on completion of the CTC, and rectal perforation was confirmed by the finding of perirectal air on the CT scan. The perforation caused hypogastric pain, discomfort and hematochezia. The treatment was conservative, consisting of antibiotics, no oral intake and bowel rest. A literature review was conducted and the characteristics of previously reported events of perforation during CTC were summarized. Although rare, bowel perforation may occur during CTC. Awareness of this complication will lead to prompt diagnosis and timely management.