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Case Reports
. 2024 Jul 12;16(7):e64418.
doi: 10.7759/cureus.64418. eCollection 2024 Jul.

Ischemic Sigmoid Colon Presenting As Hemoperitoneum From an Avulsed Mesocolon During Colonoscopy: A Case Report and Literature Review

Mueen Megdadi  1 , Segala Tita  2 , Aqib Javed  2 , Jamal Zahir  2 , Thomas Kang  1
Affiliations
Case Reports

Ischemic Sigmoid Colon Presenting As Hemoperitoneum From an Avulsed Mesocolon During Colonoscopy: A Case Report and Literature Review

Mueen Megdadi et al. Cureus. .

Abstract

Colonoscopy has proven efficacy for both screening and diagnostic purposes. Although the risk of complications during colonoscopy is low, it is not negligible. As such, we present the case of a 72-year-old male patient who presented with abdominal pain and positive peritoneal signs post-colonoscopy. He was found to have anemia and acute on chronic kidney disease. An abdominal CT scan found evidence of hemoperitoneum. Subsequently, he underwent a diagnostic laparoscopy converted into an open exploratory laparotomy to identify the source of bleeding, an avulsed mesocolon. A review of the literature regarding colonoscopy and associated complications is discussed, highlighting the importance of risk stratification to better treat patients and prognosticate outcomes.

Keywords: avulsed mesocolon; colonoscopy; hemoperitoneum; ischemic colon; sigmoid colon.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Axial view of non-contrast-enhanced CT of the abdomen and pelvis illustrating the hemoperitoneum
(a) Free fluid anterolateral to the liver. (b) Pelvic-free fluid consistent with hemoperitoneum. Green circles signify the hemoperitoneum.
Figure 2
Figure 2. Intraoperative ischemic sigmoid colon visualized via exploratory laparotomy
(a) Avulsed sigmoid mesentery. (b) Ischemic sigmoid colon.
See this image and copyright information in PMC

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