Abstract
A 27-year-old female with a history of Crohn’s disease and familial adenomatous polyposis (FAP) presented to the emergency department (ED) with severe abdominal pain after an endoscopic exam. Chest and abdominal radiographs revealed massive pneumoperitoneum and the patient underwent emergent exploratory surgery. Herein, we discuss the management and outcomes of this case. The importance of a thorough history and physical exam when evaluating for an acute abdomen and thus the development of a successful management plan is also underscored.
Highlights
Iatrogenic perforations are an uncommon but clinically and potentially catastrophic complication of endoscopic procedures
Immediate identification and emergent surgical consultation are needed and a delay in care may result in rapid patient demise
We describe a case of iatrogenic perforation where the patient without emergent intervention would have likely succumbed to her condition
Summary
Iatrogenic perforations are an uncommon but clinically and potentially catastrophic complication of endoscopic procedures. The incidence of iatrogenic perforations is thought to be increasing because of the expanded use of endoscopic screening programs and the widening array indications for endoscopic procedures [1]. It is imperative that the emergency medicine physician be eminently aware of the risks of postprocedural iatrogenic perforations and mobilizes all requisite resources without hesitation. We describe a case of iatrogenic perforation where the patient without emergent intervention would have likely succumbed to her condition.
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