Colonoscopy is a safe procedure with a low incidence of complications. Perforation is the complication most feared by the gastroenterologist. The management of benign pneumoperitoneum after colonoscopy is controversial. It is defined as asymptomatic free intra-abdominal air or as pneumoperitoneum without peritonitis. It may not require treatment. We present this case because of its rarity and controversial treatment options. This is a 46-year-old patient followed for luminal colic Crohn's disease under Adalimumab admitted to a day hospital for a colonoscopy in the context of monitoring. The latter had objectified a severe left flare and was not totaled because of the risk it ran for the patient. On waking, the patient presented with diffuse abdominal pain that resolved after gas evacuation. An abdominal CT scan was nevertheless performed, showing right prehepatic and pericolic pneumoperitoneum without peritoneal effusion. It was decided in consultation with the surgeons to opt for digestive rest and to keep the patient under strict surveillance without starting any treatment given that the patient was asymptomatic, afebrile, hemodynamically stable and the abdominal examination was strictly normal. The patient showed no clinical worsening during the follow-up and the pneumoperitoneum clearly regressed on the follow-up CT scan. It is necessary in case of pneumoperitoneum to confront the imaging to the clinic by remaining above all a clinician in order to be able to reserve conservative treatment for well-chosen patients.
| Published in | International Journal of Medical Case Reports (Volume 1, Issue 2) |
| DOI | 10.11648/j.ijmcr.20220102.12 |
| Page(s) | 13-16 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Colonoscopy, Pneumoperitoneum, Crohn’s Disease
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APA Style
Ferdaouss Lamarti, Mohamed Borahma, Nawal Lagdali, Imane Benelbarhdadi, Fatima-Zohra Ajana, et al. (2022). Benign Pneumoperitoneum After Diagnostic Colonoscopy in a Patient Followed Up for Crohn's Disease. International Journal of Medical Case Reports, 1(2), 13-16. https://doi.org/10.11648/j.ijmcr.20220102.12
ACS Style
Ferdaouss Lamarti; Mohamed Borahma; Nawal Lagdali; Imane Benelbarhdadi; Fatima-Zohra Ajana, et al. Benign Pneumoperitoneum After Diagnostic Colonoscopy in a Patient Followed Up for Crohn's Disease. Int. J. Med. Case Rep. 2022, 1(2), 13-16. doi: 10.11648/j.ijmcr.20220102.12
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Download@article{10.11648/j.ijmcr.20220102.12,
author = {Ferdaouss Lamarti and Mohamed Borahma and Nawal Lagdali and Imane Benelbarhdadi and Fatima-Zohra Ajana and Omar El Aoufir and Laila Laamrani},
title = {Benign Pneumoperitoneum After Diagnostic Colonoscopy in a Patient Followed Up for Crohn's Disease},
journal = {International Journal of Medical Case Reports},
volume = {1},
number = {2},
pages = {13-16},
doi = {10.11648/j.ijmcr.20220102.12},
url = {https://doi.org/10.11648/j.ijmcr.20220102.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmcr.20220102.12},
abstract = {Colonoscopy is a safe procedure with a low incidence of complications. Perforation is the complication most feared by the gastroenterologist. The management of benign pneumoperitoneum after colonoscopy is controversial. It is defined as asymptomatic free intra-abdominal air or as pneumoperitoneum without peritonitis. It may not require treatment. We present this case because of its rarity and controversial treatment options. This is a 46-year-old patient followed for luminal colic Crohn's disease under Adalimumab admitted to a day hospital for a colonoscopy in the context of monitoring. The latter had objectified a severe left flare and was not totaled because of the risk it ran for the patient. On waking, the patient presented with diffuse abdominal pain that resolved after gas evacuation. An abdominal CT scan was nevertheless performed, showing right prehepatic and pericolic pneumoperitoneum without peritoneal effusion. It was decided in consultation with the surgeons to opt for digestive rest and to keep the patient under strict surveillance without starting any treatment given that the patient was asymptomatic, afebrile, hemodynamically stable and the abdominal examination was strictly normal. The patient showed no clinical worsening during the follow-up and the pneumoperitoneum clearly regressed on the follow-up CT scan. It is necessary in case of pneumoperitoneum to confront the imaging to the clinic by remaining above all a clinician in order to be able to reserve conservative treatment for well-chosen patients.},
year = {2022}
}
TY - JOUR T1 - Benign Pneumoperitoneum After Diagnostic Colonoscopy in a Patient Followed Up for Crohn's Disease AU - Ferdaouss Lamarti AU - Mohamed Borahma AU - Nawal Lagdali AU - Imane Benelbarhdadi AU - Fatima-Zohra Ajana AU - Omar El Aoufir AU - Laila Laamrani Y1 - 2022/06/16 PY - 2022 N1 - https://doi.org/10.11648/j.ijmcr.20220102.12 DO - 10.11648/j.ijmcr.20220102.12 T2 - International Journal of Medical Case Reports JF - International Journal of Medical Case Reports JO - International Journal of Medical Case Reports SP - 13 EP - 16 PB - Science Publishing Group SN - 2994-7049 UR - https://doi.org/10.11648/j.ijmcr.20220102.12 AB - Colonoscopy is a safe procedure with a low incidence of complications. Perforation is the complication most feared by the gastroenterologist. The management of benign pneumoperitoneum after colonoscopy is controversial. It is defined as asymptomatic free intra-abdominal air or as pneumoperitoneum without peritonitis. It may not require treatment. We present this case because of its rarity and controversial treatment options. This is a 46-year-old patient followed for luminal colic Crohn's disease under Adalimumab admitted to a day hospital for a colonoscopy in the context of monitoring. The latter had objectified a severe left flare and was not totaled because of the risk it ran for the patient. On waking, the patient presented with diffuse abdominal pain that resolved after gas evacuation. An abdominal CT scan was nevertheless performed, showing right prehepatic and pericolic pneumoperitoneum without peritoneal effusion. It was decided in consultation with the surgeons to opt for digestive rest and to keep the patient under strict surveillance without starting any treatment given that the patient was asymptomatic, afebrile, hemodynamically stable and the abdominal examination was strictly normal. The patient showed no clinical worsening during the follow-up and the pneumoperitoneum clearly regressed on the follow-up CT scan. It is necessary in case of pneumoperitoneum to confront the imaging to the clinic by remaining above all a clinician in order to be able to reserve conservative treatment for well-chosen patients. VL - 1 IS - 2 ER -
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