Medical Mystery: An Unusual Complication of Colonoscopy-The Answer

摘要

to the editor: The medical mystery in the October 4 issue1 involved a 69-year-old man with left inguinoscrotal erythema, swelling, and tenderness after colonoscopy, during which he had un-. dergone polypectomy of a moderately dysplastic tubular adenoma of the sigmoid colon. A computed tomographic (CT) scan of the patient's pelvis revealed free air in the left hemiscrotum (Fig. 1A). Further CT images of the abdomen and pelvis revealed marked diverticular disease affecting the distal colon and widespread gas in the retroperi-toneal tissues, spreading along the left renal fascia (Fig. IB) and along the left psoas muscle down the left paracolic gutter, extending to the anterior abdominal wall and into the left hemiscrotum. A diagnosis of Fournier's gangrene secondary to retroperitoneal perforation of the colon during colonoscopy was made