Abstract

GASPAR, Hugo  and  MORAIS, Vânia. Colonoscopy: when preparation becomes a complication. Rev Port Med Geral Fam [online]. 2020, vol.36, n.2, pp.186-193. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i2.12461.

Introduction: Colonoscopy is recommended for colorectal cancer early diagnostic due to its elevated incidence and mortality in Portugal. It is the first-line screening test when suggestive colon or rectal signs and symptoms are present. Like any other medical procedure, colonoscopy is not exempt from complications, which can happen in several stages: in the bowel preparation, in sedation/analgesia or during the colonoscopic examination itself. This is a case report of an intestinal preparation-related complication for colonoscopy with sodium picosulfate/magnesium citrate, proving the essential role of the family physician as a manager of the patient's health. Case report: Fifty-six-year-old woman, autonomous regarding her daily activities, with a history of arterial hypertension and hemorrhoidal disease, presented to our medical center for sporadic rectal bleeding episodes, plus anal pain and lower quadrant discomfort with several years of evolution. A colonoscopy was requested for diagnostic investigation. During the intestinal preparation, the patient had a syncopal episode resulting in a right parietal fracture with conscience loss and requiring hospitalization. Recovery was longer than expected and, after two years, the patient remains with memory, naming and concentration deficits confirmed by neuropsychological evaluation. Several attempts for resuming professional activity were made; however, the patient was unable to do it. Commentary: Although colonoscopy complications are uncommon, their outcome can affect the quality of patients’ life in the short, medium or long term and, therefore, should be considered before prescribing the exam. Even though managing the reduced consultation time is a necessity, it is important to be alert to the possible complications stage-related with the procedure in order to inform, clarify and capacitate our patients about its consequences.

Keywords : Colonoscopy; Cathartics; Adverse effects; Electrolyte imbalance.

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