Published online Aug 16, 2016. doi: 10.12998/wjcc.v4.i8.238
Peer-review started: March 2, 2016
First decision: April 15, 2016
Revised: May 4, 2016
Accepted: May 31, 2016
Article in press: June 2, 2016
Published online: August 16, 2016
A 73-year-old man underwent endoscopic mucosal resection (EMR) of a 20-mm flat elevated lesion on the transverse colon. The morning after the procedure, he started to have severe right upper quadrant pain after his first meal. A computed tomography scan revealed free air and a stomach filled with food. He was diagnosed to have delayed post-EMR intestinal perforation. He underwent emergent colonoscopy and clipping of the perforated site. He was discharged 8 d after the endoscopic closure without the need for surgical intervention. The meal was not the cause of the colon transversum perforation.
Core tip: The prompt and adequate management of post-operative gastrointestinal perforation is imperative. For delayed perforations, surgical management is the most common option. Herein we report a case of delayed colonic perforation that was successfully repaired by an endoscopic approach, even after the patient ingested food. We describe the techniques and highlight the importance of adequate bowel preparation for a favorable outcome.