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Case Reports
. 2019 Oct;12(5):403-406.
doi: 10.1007/s12328-019-00970-2. Epub 2019 Apr 1.

Non-occlusive mesenteric ischemia induced by a polyethylene glycol with ascorbate-based colonic bowel preparation

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Case Reports

Non-occlusive mesenteric ischemia induced by a polyethylene glycol with ascorbate-based colonic bowel preparation

Rindo Ishii et al. Clin J Gastroenterol. 2019 Oct.

Abstract

Although conventional bowel preparation for colonoscopy rarely causes serious complications, such complications can be fatal and, therefore, require early recognition and prompt treatment. Herein, we report a case of non-occlusive mesenteric ischemia (NOMI) induced by polyethylene glycol with an ascorbate component (PEG + Asc) that was used as a colonic bowel preparation. An- 82-year-old woman with a medical history of hypertension, atrial fibrillation and mild chronic renal failure received a cancer screening colonoscopy. Four hours after the administration of PEG + Asc, she vomited and gradually developed abdominal distention. She went into hypovolemic shock, and a CT scan revealed a distal colon obstruction caused by fecal material. A colonoscopy identified focal necrotic mucosa between the rectum and descending colon, suggesting the occurrence of irreversible intestinal necrosis; consequently, she underwent emergency surgery. The operative and pathological findings showed a discontinuous area of necrosis from the anal margin to the ileum without thrombotic change in the main mesenteric arteries, consistent with a diagnosis of NOMI. NOMI is a rare but fatal disease that can advance to an irreversible stage before a definite diagnosis can be made. Since PEG + Asc is a hypertonic laxative solution, the possibility that dehydration might cause severe secondary complications must be considered.

Keywords: Ascorbate component; Bowel preparation; Colonoscopy; Non-occlusive mesenteric ischemia (NOMI).

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References

    1. N Engl J Med. 1958 May 1;258(18):879-81 - PubMed
    1. Surg Today. 2005;35(3):185-95 - PubMed
    1. Ann Surg. 2007 Aug;246(2):229-35 - PubMed
    1. Am J Gastroenterol. 2008 Apr;103(4):883-93 - PubMed
    1. Clin Case Rep. 2016 Feb 02;4(3):307-9 - PubMed

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