Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2016; 22(11): 3285-3288
Published online Mar 21, 2016. doi: 10.3748/wjg.v22.i11.3285
Contained colonic perforation due to cecal retroflexion
Zhuo Geng, Deepak Agrawal, Amit G Singal, Stephen Kircher, Samir Gupta
Zhuo Geng, Department of Internal Medicine, Case Western Reserve University - Metrohealth Medical Center, Cleveland, OH 44109, United States
Deepak Agrawal, Amit G Singal, Department of Internal Medicine, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
Stephen Kircher, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
Samir Gupta, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, United States
Samir Gupta, Department of Internal Medicine, Division of Gastroenterology, and the Moores Cancer Center, University of California San Diego, San Diego, CA 92103, United States
Author contributions: Geng Z, Gupta S, Singal AG and Agrawal D contributed to conception and design, analysis and interpretation of data; Geng Z and Gupta S contributed to drafting of the article; all authors contributed to critical revision of the article for important intellectual content and final approval of the article.
Supported by (in part) Merit Review Award number 1 I01 HX001574-01A1 (Gupta, PI) from the United States Department of Veterans Affairs Health Services Research and Development Service of the VA Office of Research and Development. The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs.
Institutional review board statement: The study was reviewed and approved by the University of Texas Southwestern Institutional Review Board, with a waiver of the informed consent requirement for human subjects research.
Informed consent statement: A waiver of informed consent was granted by the University of Texas Southwestern Institutional Review Board.
Conflict-of-interest statement: None of the authors have any relevant financial or personal conflicts of interests to declare related to this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Samir Gupta, MD, MSCS, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Dr, MC 111D, San Diego, CA 92161, United States. s1gupta@ucsd.edu
Telephone: +1-858-5528585 Fax: +1-858-5524327
Received: August 4, 2015
Peer-review started: August 10, 2015
First decision: September 9, 2015
Revised: September 10, 2015
Accepted: October 23, 2015
Article in press: October 26, 2015
Published online: March 21, 2016
Processing time: 223 Days and 7.7 Hours
Abstract

Complications of cecal retroflexion performed during colonoscopy have not previously been reported to occur. We report a case of contained colonic perforation secondary to using cecal retroflexion technique to examine the colon, and review available published reports of complications associated with this technique. We conclude that complications may rarely occur with use of cecal retroflexion, and that the clinical benefit of this technique is uncertain.

Keywords: Cecal retroflexion; Colonoscopy; Cecum

Core tip: Complications and benefits of cecal retroflexion have undergone limited study. This case report of a contained colonic perforation associated with cecal retroflexion suggests that cecal retroflexion may be associated with rare complications that should be considered in the differential diagnosis of patients exposed to the technique presenting with post-colonoscopy complications.