PDF(Pubmed)
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.
METHODS: 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.
CONCLUSIONS: Despite its rarity, pharyngeal perforation should be considered a potential complication of bowel preparation for colonoscopy.
METHODS: 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.
CONCLUSIONS: Despite its rarity, pharyngeal perforation should be considered a potential complication of bowel preparation for colonoscopy.
摘要：
背景：有效的肠道清洁对于成功的结肠镜检查至关重要。泻药,如聚乙二醇，通常用于肠道准备。呕吐是肠道准备过程中常见的并发症，强烈的呕吐可能会导致食道穿孔，正如在以前的几个案例中报道的那样。然而,肠道准备期间的咽部穿孔以前没有记录。这里,我们介绍了一个在肠道准备过程中由强烈呕吐引起的咽部穿孔的病例。
方法：一名有高血压病史的38岁男性，血脂异常,糖尿病,接受血液透析治疗的终末期肾病用于评估复发性腹痛。病人抱怨颈部突然疼痛，喉咙,在肠道准备期间强烈呕吐后的前胸部。体格检查发现触诊时颈部和前胸部皮肤下有偶发性，上消化道内镜提示咽部穿孔。穿孔部位位于食管上括约肌上方，这将其与Boerhaave综合征区分开来。在与胸外科医生和耳鼻喉科医生协商后选择了保守的医疗管理，考虑到病人的轻微症状，生命体征稳定,和小尺寸的病变;穿孔解决没有内窥镜或手术干预。患者在穿孔后两周出院。
结论：尽管它很少，咽部穿孔应被视为结肠镜检查肠道准备的潜在并发症。
方法：一名有高血压病史的38岁男性，血脂异常,糖尿病,接受血液透析治疗的终末期肾病用于评估复发性腹痛。病人抱怨颈部突然疼痛，喉咙,在肠道准备期间强烈呕吐后的前胸部。体格检查发现触诊时颈部和前胸部皮肤下有偶发性，上消化道内镜提示咽部穿孔。穿孔部位位于食管上括约肌上方，这将其与Boerhaave综合征区分开来。在与胸外科医生和耳鼻喉科医生协商后选择了保守的医疗管理，考虑到病人的轻微症状，生命体征稳定,和小尺寸的病变;穿孔解决没有内窥镜或手术干预。患者在穿孔后两周出院。
结论：尽管它很少，咽部穿孔应被视为结肠镜检查肠道准备的潜在并发症。
