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APC Treatment Resulting in Pneumoperitoneum; Perforation or Just Escape of Luminal Gas?

Argon plasma coagulation (APC) is an electrocoagulation technique commonly used for treatment of gastrointestinal bleeding secondary to arteriovenous malformations (AVMs). Although this modality is generally safe, a rare complication reported is perforation. We present an elderly female, who was found to have multiple colonic AVMs which were treated with APC, however, resulted in complication of pneumoperitoneum. With absence of peritonitis and hypotension, patient was treated with needle decompression of the peritoneal space, bowel rest, and antibiotics, which resulted in a successful recovery in the absence of surgical intervention.

Author(s): Milin Patel, Tusharsindhu Chauhan and Vimal Amin

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