TTP7.08 Post-Colonoscopy Pseudo-tumour – a rare cause of post colonoscopy acute abdomen

Aim To present a rare cause of acute abdomen post colonoscopy - pseudo-tumour and to explore the management of such lesions. Presentation of case A 41-year-old male, with a change in bowel habits and a positive FIT test, underwent a routine colonoscopy (biopsies from ascending colon and Terminal Ileum) without complications. The following day, he presented with an acute abdomen, with raised inflammatory markers and sepsis. An urgent CTAP revealed stenosing lesions in the ascending colon and small bowel, with upstream dilatation. In view of the normal colonoscopy, we postulated that this could be due to bleeding into the colonic wall from the biopsies. The patient was managed conservatively and settled. A follow-up CTAP showed complete resolution of the masses, and no further symptoms were reported. Discussion Literature suggests that the likely cause was haemorrhage, leading to laminar mural thickening. This was shown on CT scan and reported as a stenosing tumour by the radiologist. The worry was a missed tumour on colonoscopy, but we were reassured by the terminal ileal intubation, proven by biopsies. Conservative management is usually sufficient for such cases. Correlating the clinical presentation, colonoscopy, pathology and radiology results is important in management of this rare complication. Conclusion This case highlights a rare cause of acute abdomen after an uneventful colonoscopy. Awareness of such complications and correlating the various imaging modalities are crucial for optimal patient management and avoiding unnecessary surgery.