Video Tip: Post Polypectomy Syndrome | October 2021-Post Polypectomy Syndrome

Video Transcription

So, post-polypectomy syndrome usually starts straight after the colonoscopy, but it can happen also a few hours afterwards or a few days after the colonic resection. The patient  initially complains of abdominal pain, which is quite intense, I have to say, and it can get worse and it can cause fever and peritoneal signs. You might have leukocytosis and raise  CRP, but when you perform the CT scan, and we in our hospital, when we have a suspect of perforation, nowadays we only perform CT scan, we don't perform x-rays, because the  CT scans are much more reliable, then the CT scan in this case will be negative. So, you might think about post-polypectomy syndrome. These happen mostly when we resect polyp on  the right colon, when we have a polyp bigger than 20 millimetres in size, although even for a smaller polyp, when you use diathermy, it might happen that the patient might have  post-polypectomy syndrome. It's more common when you have multiple polyps resected throughout the  colon, and if the procedure takes longer, and of course, if the polyps are flat rather than polyp or pedunculated. How do we manage post-polypectomy syndrome? So, we usually admit  the patients, IV fluids, antibiotics, bowel rest, and usually in 24 hours, the patient feels better and improved, and then you are able to discharge them.

Video Summary

In this video, the speaker discusses post-polypectomy syndrome, which can occur after a colonoscopy or colonic resection. Symptoms include intense abdominal pain, fever, and peritoneal signs. The speaker mentions that leukocytosis and raised CRP levels may be present, but a CT scan is more reliable than an X-ray for diagnosing perforation. Post-polypectomy syndrome is more likely with larger polyps, use of diathermy, multiple polyps, longer procedures, and flat polyps. Management typically involves admission, IV fluids, antibiotics, bowel rest, and improvement within 24 hours. The patients can then be discharged. No credits were given in the video.

Keywords

post-polypectomy syndrome

abdominal pain

CT scan

diagnosing perforation

management