Case Reports in Gastrointestinal Medicine

Case Report

Ischemic Colitis after Colonoscopy with Bisacodyl Bowel Preparation: A Report of Two Cases

Table 2

Literature review results of ischemic colitis following colonoscopy. Search run August 2019.


First author, year	Age	Sex	Risk factors	Bowel Preparation Type Dose	Initial endoscopy characteristics Indication for endoscopy Type of endoscopy Difficult endoscopy (Y/N) Time	Onset to symptoms (hours)	Symptoms	Diagnosis	Complications	Treatment	Resolution

Wheeldon [27], 1990	59	F	SLE	NA NA	Surveillance Colonoscopy No NA	24 hours	Abdopain, vomiting, diarrhea, and hematochezia	Colonoscopy	None	Conservative	D/C 6 days
Church [31], 1995	45	F	MCTD Methotrexate and prednisone	NA	Hematochezia Flexible sigmoidoscopy Yes: “Difficult, severe pain” NA	24 hours	Abdopain and fever	Colonoscopy	Peritonitis	Loop sigmoid colostomy	NA
Cremers [32], 1998	44	F	None	PEG 3350 4 L	Abdominal pain Colonoscopy No NA	48 hours	Abdopain and hematochezia	Colonoscopy	None	Conservative	D/C 2 days
Versaci [29], 2005	43	F	SLE	NA	Altered bowel habits Colonoscopy, polypectomy No NA	4 hours	Abdopain, hematochezia, mucous, and diarrhea	Colonoscopy	None	Conservative	D/C 12 days
Vaizman [19], 2007	78	F	HTN, age	Bisacodyl/PEG 3350 NA	Surveillance Colonoscopy NA NA	Later that day	Abdopain, hematochezia, and diarrhea	Laparotomy	Necrotic sigmoid with perforation	Left hemicolectomy	NA
Arhan [28], 2009	25	F	None	Calcium sennoside sodium phosphate enema	Constipation Colonoscopy 25 mins NA NA	1 hour	Abdopain and hematochezia	Colonoscopy	None	Conservative	D/C 5 days
Kao [30], 2009	55	M	None	NA	Screening Colonoscopy NA NA	NA	Abdopain and hematochezia	Colonoscopy	None	Conservative	NA
Dong [33], 2009	54	F	None	NA	Abdominal pain Colonoscopy NA NA	3 hours	Abdopain and hematochezia	Sigmoidoscopy and CT	None	Conservative	NA
Singh-Ranger [34], 2011	49	F	None	Sodium picosulphate 20 mg	Abdominal pain and loose stool Colonoscopy NA NA	Later that evening	Abdopain and fever	CT	None	Conservative	NA
Cheng [35], 2012	NA	M	None	Sodium phosphate 90 mL	Screening Colonoscopy NA NA	Several hours	Abdopain, hematochezia, and diarrhea	Colonoscopy and CT	None	Conservative	D/C 7 days
Sapmaz [36], 2014	26	F	None	NA	Chronic diarrhea Colonoscopy NA NA	10 hours	Abdopain and hematochezia	Colonoscopy and CT	None	Conservative	D/C 5 days
Lee [37], 2014	47	F	None	PEG 3350 4 L	Screening Colonoscopy and polypectomy NA NA	7 hours	Abdopain and hematochezia	Colonoscopy and CT	None	Conservative	D/C 9 days
Lee [37], 2014	40	M	None	PEG 3350 4 L	Screening Colonoscopy No NA	18 hours	Abdopain and hematochezia	Colonoscopy and CT	None	Conservative	D/C 9 days
Silva [38], 2014 (abstract only)	67	F	COPD	NA	Screening Colonoscopy NA NA	6 hours	Abdopain and hematochezia	CT	None	Conservative	D/C 5 days
Hai-Bo Zhou [39], 2015	30	F	None	NA	Abdopain Colonoscopy NA NA	48 hours	Abdopain and hematochezia	Colonoscopy	None	Conservative	D/C 7 days
Omar [40], 2015	70	F	Age, HTN, and dyslipidemia	PEG 3350 NA	Screening Colonoscopy No 30 mins	The next day	Abdopain and hematochezia	Colonoscopy and CT	None	Conservative	NA
Solanke [41], 2016	43	M	None	PEG 3350 4 L split	Constipation Colonoscopy NA NA	6 hours	Abdopain and hematochezia	Colonoscopy and CT	None	Conservative	D/C 2 days
Zizzo [9], 2016	43	F	None	PEG 3350 4 L	Screening Colonoscopy Yes: forced exploration, with insufflation 37 mins	12 hours	Abdopain, fever, and hematochezia	CT, laparoscopy, and laparotomy	Peritonitis Transmural infarct with necrosis	Left hemicolectomy and terminal colostomy	D/C 22 days
Current case 1, 019	57	F	None	Bisacodyl/PEG 3350 15 mg/2 L	(+) positive FITT Colonoscopy Yes: tortuous NA	48 hours	Abdopain	Flexible sigmoidoscopy and CT	Hemodynamic instability GAS bacteremia	Conservative	D/C 6 days
Current case 2, 2019	69	F	IBS	Bisacodyl/PEG 3350 15 mg/2 L	Screening Colonoscopy No NA	6 days	Abdopain and hematochezia	Flexible sigmoidoscopy	None	Conservative	D/C < 1 day (no admission)

Abdopain, abdominal pain; SLE, systemic lupus erythematosus, HTN, hypertension; MCTD, mixed connect tissue disease; NA, not available; D/C, day of discharge; CT, computerized tomography; GAS, group A Streptococcus.