Complications from colonoscopy or diverticulosis?

[thlnc]

My friend had a colonoscopy for rountine evaluation. 24-48hrs after the procedure, she started having increased pain. Diverticulosis was found on colonoscopy but no evidence of diverticulitis. A polyp was also removed with no bleeding. CT of abdomen showed nothing. She continued to get worse. Went back and they did another CT and found a 8cm abcess in the lower pelvis. And things got worse from there. Ended up with colostomy etc... Could all this be related to the diverticulosis or complications from the colonostomy? Anyone have any insight?

Thanks

[CrohnieToo]

Was she enduring pain prior to the prep and colonoscopy? You mention "increased pain" after the colonoscopy. Was any previous pain increased during the prep for the scope? Could there have been a slight perforation during the colonoscopy that allowed the abscess to form? Were both CT scans read by the same radiologist? Has she gotten copies of the actual colonoscopy report, the actual CT scan reports AND the surgical report? Often the answer can be found in these reports altho the patient is not fully informed by the doctor or surgeon. Sometimes answers are found, not in the doctor's report of the procedure, but in the accompanying reports such as the Nurse's Notes.

[thlnc]

Thanks for your input. To answer your questions, no there were was no pain during prep or before the colonoscopy. My thought was that there was a perforation during the procedure. I will ask about who read the CT reports. I did see the colonoscopy report and nothing out of the ordinary took place in his report or the nurses report. She left passing gas and with no complaints. It wasn't until about 24-48hrs later that the pain started. I know that perforation is a complication of the procedure even if it is done correctly. Thanks so much. Any other insight you can give would be appreciated.

thlnc

[Jay-Jay, RN]

Diverticulosis weakens the bowel, and puts you at increased risk of perforation during a procedure such as a colonoscopy. Perforation can also happen spontaneously as a result of an abcess forming in an inflamed diverticulum. I believe the procedure itself can also irritate the bowel and cause a flareup of diverticular disease.

[DusktilDawn]

How soon after the colonoscopy was the abscess discovered? How long after the colonoscopy was the first CT done?

It's possible that the polyp removal was from an already weakened area of the bowel leading to perforation, this would be my GUESS since she developed symptoms of increased pain after 24hrs-48hrs. It's also possible that an abscess developed at the site where the polyp was removed. It's also possible that the procedure caused inflamation to the diverticuli present that lead to perforation and the development of the abscess.

Although the complications you described can both happen with diverticulosis (diverticulitis when the pouches are inflammed) and post colonoscopy.

[EndoRN]

It does sound like a micro perforation to me. I mean, if she had absolutely NO pain prior. Was that abcess in her colon? It seems doubtful to me that she developed diverticulitis from the scope if she didn't have it prior. Unless they missed an inflamed tic along the way. It seems that a perf would have shown up on the CT scan, though.

Interesting! Hope she's doing OK. You'll have to keep us posted on what you find out.