Post colonoscopy colonic perforation with parietal abscess: a rare case report


  • Manoj K. Choudhury G.I & Laparoscopic Surgeon, Nemcare Superspecialty Hospital, Bhangagarh, Guwahati Address for Correspondence:- Santipath (opposite Ambika petrol pump), 3rd byelane, Zoo Road, Guwahati- 781024, Assam, India
  • Utpal Baruah Consultant surgery, Nemcare hospital
  • S. K. M. Azharuddin DNB student, Nemcare Hospital Bhangagarh, Guwahati 781005, Assam ,India



Colonoscopy, Colonic perforation, Parietal abscess


Colonoscopy is a common method of diagnosing colon and rectum illnesses. Complications from colonoscopy are rare. However, perforation is one of the most common problems observed. The incidence is 0.005-0.085 percent. Extraperitoneal and mixed postcolonoscopy colonic perforations are classified as intraperitoneal, extraperitoneal and both combined. Extraperitoneal perforation is rare and frequently accompanied with subcutaneous emphysema and retroperitoneal abscess. Contrast CT scan is the most effective diagnostic and therapy tool. A parietal abscess after colonoscopy is quite rare. Only one incidence of post-colonoscopy retroperitoneal colonic perforation with parietal abscess has been reported. An unusual case of colonic perforation after diagnostic colonoscopy was presented with a parietal abscess on the left iliac area. The patient, a 63-year-old diabetic male, had a diagnostic colonoscopy for intestinal irregularity. Afternoon severe ache over left iliac region brought patient to doctor. Nothing notable was discovered. So, they prescribed symptomatic drugs. Symptomatic medications were prescribed but without any relief. An abdominal contrast CT was recommended to him by his doctor after a few days. This retro muscular accumulation in the left transverses abdominis muscle communicated with the sigmoid colon. No signs of peritonitis or septicemia. Patient was stable. The aspirated fluid was sent for culture and sensitivity testing, and intravenous hydration and antibiotics were commenced. Patient tolerated conservative care. The subject was discharged in 2 weeks. Diagnosis and treatment of perforation are critical to recovery.


Young KS, Kim HS, Park HJ. Adverse events related to colonoscopy: Global trends and future challenges. World journal of gastroenterology. 2019;25(2):190.

Abhinav T. Recognition of extraperitoneal colonic perforation following colonoscopy: a review of the literature. Case reports in gastroenterology. 2017;11(1):256-64.

Farley, David R. Management of colonoscopic perforations. Mayo Clinic Proceedings. Elsevier, 1997;72(8):729-33.

Nicola A2017 WSES guidelines for the management of iatrogenic colonoscopy perforation." World Journal of Emergency Surgery. 2018;13(1):1-20.

Ostyn B. Retroperitoneal abscess complicating colonoscopy polypectomy. Diseases of the colon & rectum. 1987;30(3):201-3.

Ruscelli P, Renzi C, Polistena A. Clinical signs of retroperitoneal abscess from colonic perforation: Two case reports and literature review. Medicine (Baltimore). 2018;97(45):e13176.

García-García ML, Jiménez-Ballester MÁ, Girela-Baena E, Aguayo-Albasini JL. Abdominal wall abscess secondary to colonoscopic polypectomy. Radiological management. Gastroenterol Hepatol (Engl Ed). 2017;40(7):463-4.

Reumkens A, Rondagh EJA, Bakker MC, Winkens B, Masclee AAM, Sanduleanu S. Post-colonoscopy complications: A systematic review, time trends, and meta-analysis of population-based studies. Am J Gastroenterol. 2016;111(8):1092-101.

Levenson RB, Troy KM, Lee KS. Acute abdominal pain following optical colonoscopy: CT findings and clinical considerations. AJR Am J Roentgenol. 2016;207(3):W33-40.

Lohsiriwat V. Colonoscopic perforation: incidence, risk factors, management and outcome. World J Gastroenterol. 2010;16(4):425-30.

Liang JT, Chen TC, Hung JS, Lin BR, Huang J. Long-term follow-up for patients with colonic perforation due to colonoscopy: From clinical and medicolegal viewpoints. Formos J Surg. 2017;50(6):195.

Liang JT, Chen TC, Hung JS, Lin BR, Huang J. Long-term follow-up for patients with colonic perforation due to colonoscopy: From clinical and medicolegal viewpoints. Formos J Surg. 2017;50(6):195.

Thomson SR. Iatrogenic and accidental colon injuries—what to do? Diseases of the colon & rectum. 1994;37(5):496-502.

Kavic SM, Basson MD. Management of complications of colonoscopy. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt. 2001.

Alsowaina KN, Ahmed MA, Alkhamesi NA. Management of colonoscopic perforation: a systematic review and treatment algorithm. Surg Endosc. 2019;33(12):3889-98.






Case Reports