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      Cecal perforation with an ascending colon cancer caused by upper gastrointestinal endoscopy

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          Abstract

          Colonic perforation caused by upper gastrointestinal (GI) endoscopy is extremely rare. A 69-year-old woman was referred to our hospital because of abdominal fullness. Colonoscopy could be performed only up to the hepatic flexure due to an elongated colon and residual stools. Because her symptoms improved, upper GI endoscopy was performed 11 days later. The patient developed severe abdominal pain two hours after the examination. Abdominal X-ray and computed tomography showed massive free air. Immediate laparotomy was performed for the intestinal perforation. After removal of stool, a perforation site was detected in the cecum with an invasive ascending colon cancer. Therefore, a right hemicolectomy, ileostomy, and transverse colostomy were performed. Although she developed postoperative septicemia, the patient was discharged 38 days after admission. Seven months postoperatively, the patient died of lung, liver, and brain metastases. Even in cases with a lesion that is not completely obstructed, it is important to note that air insufflations during upper GI endoscopy can perforate the intestinal wall in patients with advanced colon cancer.

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          Author and article information

          Journal
          Ther Clin Risk Manag
          Therapeutics and Clinical Risk Management
          Therapeutics and Clinical Risk Management
          Dove Medical Press
          1176-6336
          1178-203X
          2009
          2009
          4 May 2009
          : 5
          : 301-303
          Affiliations
          [1 ]Department of Gastroenterology, Jichi Medical University, Saitama Medical Center, Saitama, Japan;
          [2 ]Department of Surgery, Jichi Medical University, Saitama Medical Center, Saitama, Japan
          Author notes
          Correspondence: Hiroyuki Miyatani, Department of Gastroenterology, Jichi Medical University, Saitama Medical Center, 1-847 Amanuma, Omiya, Saitama, Saitama 330-8503, Japan, Tel +81 48 647 2111, Fax +81 48 648 5188, Email miyatani@ 123456omiya.jichi.ac.jp
          Article
          tcrm-5-301
          2697535
          19536313
          © 2009 Miyatani et al, publisher and licensee Dove Medical Press Ltd.

          This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

          Categories
          Case Report

          Medicine

          upper gastrointestinal endoscopy, fecal peritonitis, colonic perforation, colon cancer

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