Endgames Spot Diagnosis

Abdominal pain after colonoscopy

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5505 (Published 10 November 2016) Cite this as: BMJ 2016;355:i5505
  1. Joseph Dalby Sinnott, core surgical trainee1,
  2. David C Howlett, consultant radiologist2
  1. 1Department of Surgery, East Sussex Hospitals NHS Trust, Eastbourne, UK
  2. 2Department of Radiology, East Sussex Hospitals NHS Trust
  1. Correspondence to: J D Sinnott j.d.sinnott{at}gmail.com

A 43 year old woman was admitted to the surgical assessment unit with increasing abdominal pain 36 hours after a colonoscopy and polypectomy. On examination her abdomen was tender and mildly distended. Computed tomography (CT) was performed (fig 1). What is the diagnosis?

Fig 1 Computed tomography scan of abdomen

Answer

The CT shows free air in the abdomen, which is indicative of a perforated bowel. Clips …

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