Abstract

To the Editor:

Acute colonic pseudo-obstruction (ACPO) is the clinical syndrome of acute large bowel dilatation without mechanical obstruction. Typically, it develops in hospitalized or instutionalized patients with serious underlying medical and surgical conditions.¹ We report an unusual case of ACPO that happened after polypectomy was performed in an otherwise healthy individual. A 76-year-old gentleman with hypertension and chronic obstructive pulmonary disease was seen in consultation for colonoscopy for hemepositive stools. The procedure was performed using conscious sedation with 100 mcg of fentanyl and 5 mg of midazolam. During the procedure, a 20 mm pedunculated polyp was removed with standard snare excision (with monopolar cautery) by first raising it from the underlying muscularis propria by injecting saline into the submucosa under the polyp. In addition, the patient had moderate diverticular disease in the sigmoid and descending colon.