Bowel gangrene a serious condition

Dear Dr. Gott: You mentioned gangrene of the bowel in your column. I had never heard of this until recently. A friend of mine had a colonoscopy last September and had no problems detected. However, in November, she had a severe pain on a Sunday night, was sent to the emergency room of the hospital and had her colon removed the next day. Gangrene had started to occur. Up to this point, she had never had any bowel problems, so it has been hard to understand why this problem happened so suddenly. My question is, could something have happened during the colonoscopy that she wasn’t told about that might have caused this to happen?

Dear Reader: One of the most serious consequences – fortunately rare – of colonoscopy is bowel perforation. During the procedure, the instrument sometimes pokes a hole in the colon that can lead to serious infection, terminating in gangrene if not treated. Symptoms ordinarily appear in a matter of hours but may be masked for several days. A two-month wait would be virtually impossible. Therefore, I doubt that the colonoscopy caused the gangrene your friend experienced.

Bowel gangrene is more often the consequence of colon ischemia, arterial blockage of colonic segments leading to death of intestinal tissue. In the elderly, sudden or recurring abdominal discomfort must include bowel gangrene as a possible cause. For this reason, emergency scanning studies are necessary for diagnosis and to define the extent of the problem before surgery, the only lifesaving cure.

Abdominal pain in children is commonly caused by appendicitis. However, in adults, there are many other causes, ranging from gallbladder disease and peptic ulcer to bowel ischemia and cancer.

I believe that your friend had appropriate treatment for her colonic problem, which was not related to her colon study two months before.