Rigours, nausea, vomiting...

A 71-year-old, previously healthy male was presented with rigours, nausea, vomiting and right upper quadrant pain, 6 hrs post uncomplicated colonoscopy polypectomy. At presentation, he was febrile at 40.1 °C but hemodynamically stable. The abdominal CT revealed substantial colonic thickening and pneumatosis intestinalis surrounding the polypectomy site. The abdominal Ct report is shown in the figure.

Within 24 h post-procedure, the patient became hypotensive and was admitted to ICU for septic myocardial depression. Bloods showed multi-organ derangement with leucocytosis, lactic acidosis, haemolytic anaemia and hyperbilirubinemia. The diagnosis was made, and the patient was given intense conservative antibiotics. After four days, the patient’s symptoms improved, and he was discharged after 10days.