We report a case of a healthy man who evolved acute abdominal compartment syndeome due to massive retroperitoneal gas gangrene after colonoscopic polypectomy without a bowel perforation. Methods: My abstract is case report. It does not have Methods Results: Case report: A 60-year-old man was admitted for colonoscopic polypectomy. Except for previous subtotal gastrectomy operation
for duodenal perforation, He had no medical problem. At previous colonoscopy, there were three colonic polyps in sigmoid colon and each polyp’s RG7420 nmr size were about 6∼10 mm. Colonic polypectomy was performed without acute complication. About twelve hours later, the patient complained of severe left abdominal and left back pain. He had leukocytosis, high level of CRP and severe tenderness of left abdomen. His chest and abodminal x-ray had non-specific findings. Dasatinib purchase With prophylactic antibiotics for colonic microperforation, we checked abdominal computed tomography (CT). Abdominal CT revealed mild myofascitis on left psoas muscle with no significant colonic perforation. Although continuous
antibiotics therapy with pain control, his pain was aggravation. The next day, his abdomen was distended and his following labs were getting worse. We checked magnetic
resonance imaging (MRI) for myofascitis on left psoas muscle, MRI showed retroperitoneal emphysema in the left psoas muscle and intraabdominal free air. The emphysema also extended to the left kidney area. He was referred to the Department of Surgery, and had performed exploratory laparotomy. During operation, a spreading retroperitoneal phlegmon with pneumoretroperitoneum were found. The exploration revealed no colonic perforation, particulary at sigmoid colon and there was no evidence of peritonitis. An extensive debridement was performed and the abdomen was closed transiently. After the operation, he had been successfully cured using antibiotic Mannose-binding protein-associated serine protease therapy. Conclusion: Conclusion: We conclude that acute abdominal compartment syndrome with gas gangrene should be considered in unclear abdominal pain after colonic polypectomy, even if the patient’s history is not typical as in the present case. Key Word(s): 1. polypectomy; 2. gas gangrene; 3. colonoscopy; Presenting Author: BING-RONG LIU Corresponding Author: BING-RONG LIU Objective: Potentially, rectal mucosa prolapse (RMP) may lead to obstructed defecation and often complicates with a series of symptoms including tenesmus, urge to defecate, constipation and mucus discharge.