title: CT findings of post-polypectomy coagulation syndrome and colonic perforation in patients who underwent colonoscopic polypectomy.
abstract: OBJECTIVE
  To investigate the clinical characteristics and computed tomography (CT) findings of post-polypectomy coagulation syndrome (PPCS) and colonic perforation in patients who have undergone colonoscopic polypectomy.
  
  
  METHODS
  Through a hospital database search, 5542 adult patients (age >40 years) who had undergone colonoscopic polypectomy from January 2011 to November 2014 were identified. After identification of patients with PPCS and colonic perforation, two abdominal radiologists reviewed the CT images of the patients in consensus.
  
  
  RESULTS
  Eight patients (0.14%) with PPCS and six patients (0.11%) with perforation were identified. Five patients were excluded for absence of CT examination, leaving four patients with PPCS and five patients with perforation included in the study. Three of the patients with perforation eventually underwent surgery, while all the patients with PPCS completely recovered with conservative management. On CT images, the involved colonic wall was longer and thicker in the PPCS group than in the perforation group. All four patients with PPCS showed a mural defect filled with fluid and stratified enhancement with surrounding infiltration. Two patients, who did not undergo surgery for perforation, did not show surrounding infiltration and fluid collection.
  
  
  CONCLUSIONS
  On CT images, PPCS shows severe mural thickening with a stratified enhancement pattern, a mural defect filled with fluid and surrounding infiltration in addition to absence of extraluminal air. In patients with perforation, absence of CT findings suggestive of surrounding inflammation or peritonitis would help in choosing non-surgical management.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, South Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Shin
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, South Korea. Electronic address: yhkrad@gmail.com.
authors.forename: Y H
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, South Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, South Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Park
mesh_terms: D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging / Q000601:surgery; D003108:Colonic Diseases / Q000000981:diagnostic imaging; D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods*