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Case Report
 
A rare case of sigmoid perforation following argon laser coagulation of gastrointestinal amyloidosis
Animesh A. Singla1, Apresh A. Singla2
1MBBS, Senior Resident, Department of Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
2MBBS, Registrar, Department of Surgery, Bankstown Hospital, Sydney, NSW, Australia.

Article ID: 100002G01AS2015
doi:10.5348/G01-2015-2-CR-2

Address correspondence to:
Animesh Arun Singla
77 Donovan Avenue
Maroubra, NSW, 2035
Australia
Phone: +61 432 582 925

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How to cite this article:
Singla A, Singla AA. A rare case of sigmoid perforation following argon laser coagulation of gastrointestinal amyloidosis. Edorium J Gastroenterol 2015;2:4–6.


Abstract
Introduction: Argon plasma coagulation (APC) is a safe technique to achieve endoscopic hemostasis and/or tissue ablation. Perforation is a rare complication. Gastrointestinal amyloidosis results in abnormal fibrillar protein deposition within the muscularis propria, leading to potential compromise in gut wall integrity.
Case Report: We report a rare case of iatrogenic sigmoid perforation secondary to APC treatment in a patient with recently diagnosed gastrointestinal amyloidosis. The patient initially presented with rectal (PR) bleeding with known gastrointestinal amyloidosis, and was found to have a lesion in her sigmoid colon. Hemostasis was achieved with APC therapy of the lesion. Over the next 24 hours, patient developed acute left iliac fossa tenderness with CT confirmed evidence of perforation. Urgent laparotomy was performed requiring rectosigmoidectomy with end colostomy.
Conclusion: These patients may represent a high-risk group for APC treatment and may require additional precautions including limiting the time and intensity of treatment.

Keywords: Amyloidosis, Argon plasma, Perforation


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Author Contributions
Animesh A. Singla – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Apresh A. Singla – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Animesh A. Singla et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.