Postpolypectomy electrocoagulation syndrome is an uncommon but well-known complication after colonscopy and polyp removal that is sometimes misdiagnosed as a colonic perforation.
Like colonic perforation, it presents with abdominal pain, fever, and leukocytosis usually but not always within twelve hours of the procedure. CT scan shows fat stranding in the mesentery and focal thickening of the colon wall. However, unlike in colonic perforation, there is no free air and this establishes the diagnosis and allows the patient to be managed with close observation, antibiotics, and nothing by mouth.
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