Annals of Coloproctology

Case Reports

Benign GI diease,Rare disease & stoma,Complication

Intestinal Perforation as a Paradoxical Reaction to Antitubercular Therapy: A Case Report: Sung Hoon Kang, Hee Seok Moon, Jae Ho Park, Ju Seok Kim, Sun Hyung Kang, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Jae Kyu Sung, Hyun Yong Jeong, Kyung Ha Lee; Ann Coloproctol. 2021;37(Suppl 1):S18-S23. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.03.16.1

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Paradoxical reactions to tuberculosis (TB) treatment are characterized by an initial improvement of the clinical symptoms followed by clinical or radiological deterioration of existing tuberculous lesions, or by development of new lesions. Intestinal perforation in gastrointestinal TB can occur as a paradoxical reaction to antitubercular therapy. A 55-year-old man visited the outpatient department with lower abdominal pain and weight loss. He was diagnosed with intestinal TB and started antitubercular therapy. After 3 months of antitubercular therapy, a colonoscopy revealed improvement of the disease. Three days after the colonoscopy, the patient visited the emergency room complaining of abdominal pain. Abdominal computed tomography revealed extraluminal air-filled spaces in the pelvic cavity. We diagnosed a small bowel perforation and performed an emergency laparotomy and a right hemicolectomy with small bowel resection. This report describes the case of intestinal perforation presenting as a paradoxical reaction to antitubercular and provides a brief literature review.

Citations

Citations to this article as recorded by

Réaction paradoxale tuberculeuse
L.-D. Azoulay, A.-L. Houist, E. Feredj, W. Vindrios, S. Gallien
La Revue de Médecine Interne.2024; 45(5): 279. CrossRef
Left hand abscess as a paradoxical reaction during treatment of disseminated tuberculosis in immunocompetent patient: case report and review of literature
Aisha Alharbi, Aseel Aljahdali, Mohamed Firoze Ahamed, Hassan Almarhabi
BMC Infectious Diseases.2024;[Epub] CrossRef
Paradoxical Reaction to Antitubercular Treatment Causing Colonic Obstruction
Akira Hokama, Yuiko Oishi, Erika Koga, Sayuri Takehara, Jiro Fujita
Chonnam Medical Journal.2022; 58(1): 52. CrossRef
Multiple drugs

Reactions Weekly.2021; 1881(1): 189. CrossRef

Pulmonary Sarcoidosis That Developed During the Treatment of a Patient With Crohn Disease by Using Infliximab: Tae Kyun Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong, Hyuk Soo Eun; Ann Coloproctol. 2017;33(2):74-77. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.74

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Abstract PDF

For inflammatory bowel disease (IBD), antitumor necrosis factor treatment offers a new direction for both patients and medical doctors. This treatment has dramatically improved the quality of life for patients with ulcerative colitis and Crohn disease (CD). However, with increasing usage and longer follow-up periods, a wider range of possible adverse effects may be encountered. We report an unusual case of pulmonary sarcoidosis developed during the treatment of a patient with CD by using infliximab. A 30-year-old male who had been treated for CD with infliximab for 18 months was admitted due to abnormal opacities on chest radiography. Chest computed tomography displayed clustered small nodules in both lobes and enlarged multiple lymph nodes. The patient was diagnosed with sarcoidosis from the results of a biopsy of the subcarinal lymph node. Lung lesions were improved five months after infliximab was stopped.

Citations

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Shin Kashima, Kentaro Moriichi, Katsuyoshi Ando, Nobuhiro Ueno, Hiroki Tanabe, Sayaka Yuzawa, Mikihiro Fujiya
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Original Article

Only the Size of Resected Polyps Is an Independent Risk Factor for Delayed Postpolypectomy Hemorrhage: A 10-Year Single-Center Case-Control Study: Hee Seok Moon, Sun Wook Park, Dong Hwan Kim, Sun Hyung Kang, Jae Kyu Sung, Hyun Yong Jeong; Ann Coloproctol. 2014;30(4):182-185. Published online August 26, 2014; DOI: https://doi.org/10.3393/ac.2014.30.4.182

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Abstract PDF

Purpose

A colonoscopic polypectomy is an important procedure for preventing colorectal cancer, but it is not free from complications. Delayed hemorrhage after a colonoscopic polypectomy is one infrequent, but serious, complication. The aim of this study was to identify the risk factors for delayed hemorrhage after a colonoscopic polypectomy.

Methods

This was a retrospective case-control study based on medical records from a single gastroenterology center. The records of 7,217 patients who underwent a colonoscopic polypectomy between March 2002 and March 2012 were reviewed, and 92 patients and 276 controls were selected. Data collected included comorbidity, use of antiplatelet agents, size and number of resected polyps, histology and gross morphology of resected polyps, resection method, and use of prophylactic hemostasis.

Results

The average time between the procedure and bleeding was 2.71 ± 1.55 days. Univariate and multivariate analyses revealed that the size of the polyps was the only and most important predictor of delayed hemorrhage after a colonoscopic polypectomy (odds ratio, 2.06; 95% confidence interval, 1.12-1.27; P = 0.03).

Conclusion

The size of resected polyps was the only independent risk factor for delayed bleeding after a colonoscopic polypectomy. The size of a polyp, as revealed by the colonoscopic procedure, may aid in making decisions, such as the decision to conduct a prophylactic hemostatic procedure.

Citations

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Risk factors for delayed colorectal postpolypectomy bleeding: a meta-analysis
Xuzhen Zhang, Xiaoxing Jiang, Liang Shi
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Xiuyan Lu, Ji Ma
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Endoscopic management of delayed bleeding after polypectomy of small colorectal polyps: two or more clips may be safe
Xue-Feng Guo, Xiang-An Yu, Jian-Cong Hu, De-Zheng Lin, Jia-Xin Deng, Ming-Li Su, Juan Li, Wei Liu, Jia-Wei Zhang, Qing-Hua Zhong
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Prophylactic clip application for large pedunculated polyps before snare polypectomy may decrease immediate postpolypectomy bleeding
Jae Seung Soh, Myeongsook Seo, Kyung-Jo Kim
BMC Gastroenterology.2020;[Epub] CrossRef
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Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
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Adverse events related to colonoscopy: Global trends and future challenges
Su Young Kim, Hyun-Soo Kim, Hong Jun Park
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Complications Following Colonoscopy in a Nationwide Standard Cohort: A Retrospective Case-control Study
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Post-polypectomy bleeding after colonoscopy on uninterrupted aspirin/non steroideal antiflammatory drugs: Systematic review and meta-analysis
Flavia Pigò, Helga Bertani, Giuseppe Grande, Federica Abate, Sara Vavassori, Rita Luisa Conigliaro
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Fernando A. Angarita, Adina E. Feinberg, Stanley M. Feinberg, Robert H. Riddell, J. Andrea McCart
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