[Abdominal compartment syndrome during endoscopic clamping of an intestinal perforation secondary to colonoscopy].
OBJECTIVE
Colonoscopy is widely used for diagnosis, treatment, and control of intestinal disorders. Intestinal perforation, although rare, is the most feared complication. Perforations can be treated by endoscopic clamping. The objective of this report was to alert specialists for the development and treatment of abdominal compartment syndrome during endoscopic clamping of an intestinal perforation secondary to colonoscopy.


METHODS
This is a 60 years old female, physical status ASA II, who underwent colonoscopy under sedation. During the exam, an accidental intestinal perforation was observed, and it was decided to attempt the endoscopic clamping of the perforation. The patient developed abdominal pain and distension, pneumoperitoneum, abdominal compartment syndrome, dyspnea, and cardiovascular instability. Emergency abdominal puncture was done with clinical improvement until urgent laparotomy was performed. After exploratory laparotomy and stitching of the perforation, the patient presented good clinical evolution.


CONCLUSIONS
Endoscopic clamping of an intestinal perforation secondary to colonoscopy can contribute for the development of hypertensive pneumoperitoneum and abdominal compartment syndrome with severe clinical repercussions that demand immediate treatment. Capable professionals and adequate technical resources can be determinant of the prognosis of the patient.
Hospital das Clínicas, UFMG, BH. balourenco@hotmail.com
Magda Lourenço
ML
Fernandes
Kleber Costa de Castro
KC
Pires
Paulo Henrique Baumgratz
PH
Chimelli
Márcia Rodrigues Neder
MR
Issa
D000005:Abdomen; D003106:Colon / Q000293:injuries*; D003113:Colonoscopy; D003161:Compartment Syndromes / Q000209:etiology* / Q000628:therapy*; D003250:Constriction; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000628:therapy*; D007431:Intraoperative Complications / Q000628:therapy*; D008875:Middle Aged