Abstract
Interventional endoscopic procedures performed in the anorectum may occasionally lead to iatrogenic complications which require prompt dedicated imaging investigation to allow a correct therapeutic choice. High-risk procedures include balloon dilatation, polypectomy, endoscopic mucosal resection and submucosal dissection.
The role of plain radiographs is limited in the investigation of iatrogenic rectal perforations. Conversely, although with concerns for ionising radiation exposure, multidetector CT including unenhanced and post-contrast acquisitions with multiplanar reconstructions represents the ideal technique to depict iatrogenic rectal perforation, haemorrhage and infections. In selected patients, the preliminary rectal administration of diluted water-soluble contrast may be beneficial to confirm or exclude iatrogenic perforation and to differentiate between intra- and extraperitoneal injuries. Optional CT angiography or excretory-phase acquisitions may be required, respectively, to detect active bleeding and urine leakage from associated injuries to the lower urinary tract.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Paspatis GA, Dumonceau JM, Barthet M et al (2014) Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy 46:693–711
Sartelli M, Viale P, Catena F et al (2013) 2013 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg 8:3
Hellinger MD (2002) Anal trauma and foreign bodies. Surg Clin N Am 82:1253–1260
Borofsky S, Taffel M, Khati N et al (2015) The emergency room diagnosis of gastrointestinal tract perforation: the role of CT. Emerg Radiol 22:315–327
Park JS, Kang SB, Kim DW et al (2007) Iatrogenic colorectal perforation induced by anorectal manometry: report of two cases after restorative proctectomy for distal rectal cancer. World J Gastroenterol 13:6112–6114
McGrath V, Fabian TC, Croce MA et al (1998) Rectal trauma: management based on anatomic distinctions. Am Surg 64:1136–1141
Weinberg JA, Fabian TC, Magnotti LJ et al (2006) Penetrating rectal trauma: management by anatomic distinction improves outcome. J Trauma 60:508–513; discussion 513–514
Saddala P, Ramanathan S, Tirumani SH et al (2015) Complications of minimally invasive procedures of the abdomen and pelvis: a comprehensive update on the clinical and imaging features. Emerg Radiol 22:283–294
Kim DH, Pickhardt PJ, Taylor AJ et al (2008) Imaging evaluation of complications at optical colonoscopy. Curr Probl Diagn Radiol 37:165–177
Bondia JM, Anderson SW, Rhea JT et al (2009) Imaging colorectal trauma using 64-MDCT technology. Emerg Radiol 16:433–440
Tonolini M (2013) Images in medicine: diagnosis and pre-surgical triage of transanal rectal injury using multidetector CT with water-soluble contrast enema. J Emerg Trauma Shock 6:213–215
Jaeckle T, Stuber G, Hoffmann MH et al (2008) Acute gastrointestinal bleeding: value of MDCT. Abdom Imaging 33:285–293
Horton KM, Jeffrey RB Jr, Federle MP et al (2009) Acute gastrointestinal bleeding: the potential role of 64 MDCT and 3D imaging in the diagnosis. Emerg Radiol 16:349–356
Khati NJ, Sondel Lewis N, Frazier AA et al (2015) CT of acute perianal abscesses and infected fistulae: a pictorial essay. Emerg Radiol 22:329–335
Wax BN, Katz DS, Badler RL et al (2006) Complications of abdominal and pelvic procedures: computed tomographic diagnosis. Curr Probl Diagn Radiol 35:171–187
Glynne-Jones R, Northover JM, Cervantes A (2010) Anal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v87–v92
Taylor AK, Zembower TR, Nadler RB et al (2012) Targeted antimicrobial prophylaxis using rectal swab cultures in men undergoing transrectal ultrasound guided prostate biopsy is associated with reduced incidence of postoperative infectious complications and cost of care. J Urol 187:1275–1279
Liss MA, Taylor SA, Batura D et al (2014) Fluoroquinolone resistant rectal colonization predicts risk of infectious complications after transrectal prostate biopsy. J Urol 192:1673–1678
Gyorfi JR, Otteni C, Brown K et al (2014) Peri-procedural povidone-iodine rectal preparation reduces microorganism counts and infectious complications following ultrasound-guided needle biopsy of the prostate. World J Urol 32:905–909
Hwang EC, Jung SI, Seo YH et al (2015) Risk factors for and prophylactic effect of povidone-iodine rectal cleansing on infectious complications after prostate biopsy: a retrospective cohort study. Int Urol Nephrol 47:595–601
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Tonolini, M. (2016). Imaging Complications of Anorectal Endoscopic Procedures. In: Tonolini, M. (eds) Imaging Complications of Gastrointestinal and Biliopancreatic Endoscopy Procedures. Springer, Cham. https://doi.org/10.1007/978-3-319-31211-8_15
Download citation
DOI: https://doi.org/10.1007/978-3-319-31211-8_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-31209-5
Online ISBN: 978-3-319-31211-8
eBook Packages: MedicineMedicine (R0)