Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2022; 10(33): 12375-12379
Published online Nov 26, 2022. doi: 10.12998/wjcc.v10.i33.12375
Colon mucosal injury caused by water jet malfunction during a screening colonoscopy: A case report
Parth Patel, Chien-Huan Chen
Parth Patel, Chien-Huan Chen, Division of Gastroenterology, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, United States
Author contributions: Patel P wrote the manuscript draft, revised; Chen CH reviewed and revised manuscript and is the article guarantor; all authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained for this case report and patient consented verbally and provided written consent for the procedure.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Parth Patel, MD, Postdoctoral Fellow, Division of Gastroenterology, Department of Internal Medicine, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8124, St. Louis, MO 63110, United States. parth.a.patel@wustl.edu
Received: August 11, 2022
Peer-review started: August 11, 2022
First decision: September 25, 2022
Revised: October 20, 2022
Accepted: October 26, 2022
Article in press: October 26, 2022
Published online: November 26, 2022
Processing time: 104 Days and 7.3 Hours
Abstract
BACKGROUND

Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation, bleeding, infection, and post-polypectomy syndrome. True device related adverse events are rarely reported in the literature.

CASE SUMMARY

We report a case of a 51-year-old patient without past medical history who presented for her first screening colonoscopy. The patient was thought to have friable mucosa in the cecum and oozed upon water irrigation during screening colonoscopy. It was later identified that the colonoscope used during the index procedure had malfunctioned and produced a pin-point water jet which damaged the colon mucosa of cecum. The maintenance service identified a piece of rubber fragment lodged in the instrument component at the tip of the scope, resulting in high pressure water jet. Repeat colonoscopy with a functioning colonoscope confirmed normal colon mucosa without friability.

CONCLUSION

This is the first report of mucosa injury from a colonoscope water jet malfunction. Endoscopists should recognize the potential for endoscopic malfunction.

Keywords: Iatrogenic disease; Colonoscopy; Water jet injury; Friable colon mucosa; Case report

Core Tip: We report a case of colon mucosal injury due to a colonoscope water jet malfunction. During a screening colonoscopy, a patient was found to have friable oozing colon mucosa upon water irrigation. We later found that the water jet of the colonoscope was abnormally narrow with high pressure, resulting in mucosal injury. Removal of a piece of rubber lodged at the tip of the scope normalized the water pressure. The patient’s subsequent colonoscopy showed normal colon mucosa. This is the first reported case of iatrogenic injury from a colonoscope water jet malfunction.