Colonic perforation after computed tomographic colonography in a patient with fibrostenosing Crohn's disease.
Computed tomographic colonography (CTC) offers great promise in the management of patients with disorders of the colon. Few complications have been reported with its use thus far. We describe herein a case of colonic perforation during CTC in a patient with active stenosing ileocolonic Crohn's disease. To our knowledge, this is the first reported case of CTC-related perforation in the setting of Crohn's disease, and the third reported perforation overall. Perforation likely occurred in this case due to barotrauma in the setting of colonic strictures and an inflamed, weakened colonic wall. Physician awareness of the increased risk of perforation with CTC in the setting of inflammatory and/or obstructive disease of the colon will allow for improved clinical decision-making in the care of these patients.
Triester
Stuart L
SL
Division of Gastroenterology and Hepatology, Mayo Clinic in Scottsdale, Scottsdale, Arizona 85259, USA.
Hara
Amy K
AK
Young-Fadok
Tonia M
TM
Heigh
Russell I
RI
D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods; D023881:Colonography, Computed Tomographic / Q000009:adverse effects* / Q000379:methods; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000473:pathology; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D007813:Laparotomy / Q000379:methods; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome