Résumé
Les auteurs présentent une complication rare de coloscopie qui est survenue chez un patient de 75 ans. L’indication á l’examen était d’exclure une lésion néoplasique caecale et sigmoïdienne. Le sigmoide présentait une sévère diverticulose et fut perforé par le fibroscope dont l’extrémité était alors á l’angle droit. La perforation était extrapéritonéale et fut suivie d’un emphysème sous-cutané grave accompagné de troubles respiratoires. Une surveillance étroite fut nécessaire.
Une nutrition entérale sans résidus et l’administration d’antibiotiques furent suffisants pour soigner la fistule borgne mesurant 8 × 1 × 1 cm.
6 ans plus tard le patient va bien sans complication.
Summary
The authors present a rare complication of a colonoscopy which occured in a 75 year old man. The procedure was indicated in order to exclude a neoplastic lesion of the caecum and sigmoid colon. The sigmoid colon showed evidence of severe diverticulosis and was perforated by the fiberscope, the tip of which was located at the right colic angle at the time. The perforation was extraperitoneal and was complicated by a severe subcutaneous emphysema and respiratory difficulties.
Close monitoring, a non residue enterai nutrition, and antibiotic therapy were sufficient in order to cure a 8 by 1 by 1 cm fistula.
Six years later the patient is alive and well without sequela.
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Voirol, M., Male, P.J., Loizeau, E. et al. Perforation sigmoïdienne avec emphysème sous-cutané au cours d’une coloscopie, son traitement conservateur. Acta Endosc 14, 67–70 (1984). https://doi.org/10.1007/BF02963022
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DOI: https://doi.org/10.1007/BF02963022