Kim G, Lee WH, Kang S, Moon JR, Lee YS, Son JH, Kim NH, Kim JW. Vomiting-induced pharyngeal perforation during bowel preparation for colonoscopy: A case report. World J Clin Cases 2024; 12(18): 3615-3621 [PMID: 38983420 DOI: 10.12998/wjcc.v12.i18.3615]
Corresponding Author of This Article
Seokin Kang, MD, Assistant Professor, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, 170, Juhwa-ro, Ilsanseo-gu, Goyang 10380, South Korea. seokinkang@paik.ac.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 26, 2024; 12(18): 3615-3621 Published online Jun 26, 2024. doi: 10.12998/wjcc.v12.i18.3615
Vomiting-induced pharyngeal perforation during bowel preparation for colonoscopy: A case report
Geonhee Kim, Won Hyuk Lee, Seokin Kang, Jung Rock Moon, Yoon Suk Lee, Jun Hyuk Son, Nam-Hoon Kim, Jong Wook Kim
Geonhee Kim, Won Hyuk Lee, Seokin Kang, Jung Rock Moon, Yoon Suk Lee, Jun Hyuk Son, Nam-Hoon Kim, Jong Wook Kim, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, South Korea
Co-first authors: Geonhee Kim and Won Hyuk Lee.
Author contributions: Kim G and Lee WH contributed equally to this work as co-first authors; Kim G, Lee WH, and Kang S contributed to manuscript writing and editing; Son JH and Kim JW contributed to data collection; Moon JR and Lee YS contributed to data analysis; Kang S and Kim NH contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: The institutional review board of Ilsan Paik Hospital approved this study (approval number 2024-03-011). Informed written consent was waived by the institutional review board.
Conflict-of-interest statement: All authors declare that they have no conflict 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: Seokin Kang, MD, Assistant Professor, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, 170, Juhwa-ro, Ilsanseo-gu, Goyang 10380, South Korea. seokinkang@paik.ac.kr
Received: March 13, 2024 Revised: April 22, 2024 Accepted: April 25, 2024 Published online: June 26, 2024 Processing time: 96 Days and 23.9 Hours
Abstract
BACKGROUND
Effective bowel cleansing is essential for a successful colonoscopy. Laxatives, such as polyethylene glycol, are commonly used for bowel preparation. Vomiting is a frequent complication during bowel preparation, and forceful vomiting can potentially lead to esophageal perforation, as reported in several previous cases. However, pharyngeal perforation during bowel preparation has not been previously documented. Here, we present a case of pharyngeal perforation induced by forceful vomiting during bowel preparation.
CASE SUMMARY
A 38-year-old man with a history of hypertension, dyslipidemia, diabetes mellitus, and end-stage renal disease on hemodialysis was admitted for evaluation of recurrent abdominal pain. The patient complained of sudden pain in the neck, throat, and anterior chest following forceful vomiting during bowel preparation. Physical examination revealed crepitus under the skin of the neck and anterior chest on palpation, and upper gastrointestinal endoscopy revealed pharyngeal perforation. The perforation site was located above the upper esophageal sphincter, which distinguished it from Boerhaave’s syndrome. Conservative medical management was chosen after consultation with a thoracic surgeon and an otolaryngologist, considering the patient's mild symptoms, stable vital signs, and the small size of the lesion; the perforation resolved without endoscopic or surgical intervention. The patient was discharged from hospital two weeks after the perforation.
CONCLUSION
Despite its rarity, pharyngeal perforation should be considered a potential complication of bowel preparation for colonoscopy.
Core Tip: Vomiting is a common complication of bowel preparation. Forceful vomiting can lead to esophageal perforation, as reported in several prior cases. However, pharyngeal perforation during bowel preparation has not been reported previously. Here, we present a rare case of pharyngeal perforation caused by forceful vomiting during bowel preparation. The perforation was resolved with conservative medical management. Pharyngeal perforation should be considered a potential complication during bowel preparation for colonoscopy when sudden pain in the neck, throat, and anterior chest occurs following forceful vomiting. Early recognition and prompt management are important in vomiting-induced pharyngeal perforation during bowel preparation.
