Routine Colonoscopy Results in Cardiac Arrest

Case Overview

This case involves a sixty-seven-year-old male patient with a history of HTN, diabetes mellitus type 2, and colonic polyps. The patient had no prior history of cancer and was generally in good health. He presented for a routine colonoscopy and subsequently developed severe hypotension during the procedure. The patient’s blood pressure remained very low after the procedure was aborted and began to go into respiratory failure. The patient was intubated and given three doses of epinephrine. The patient remained unstable over the next five days but expired shortly after with the cause of death being cardiac arrest.

Questions to the Gastroenterology expert and their responses

Is this a known complication of the procedure?

This is not a known complication of the procedure but certain patients must be screened before any surgical procedure no matter how minor the case may be. Pre-existing hypertension and diabetes are not necessarily contraindications but would warrant closer monitoring of such patients. Severe bradycardia and hypotension are relatively uncommon complications. If it does develop, the procedure should be stopped immediately and ACLS protocol should be followed.

About the expert

This expert is the Associate Division Chief for Medical Affairs for ther Division of Gastroenterology at his current institution. He is also a member of the American Gastroenterological Association's Clinical Practice and Quality Management Committee, and regularly publishes on health care quality and policy. He also has an MPH in epidemiology and is an experienced health services researcher.