Abstract
RATIONALE: Colonoscopy is a widely used diagnostic and therapeutic procedure with a low risk of serious adverse events. Acute bilateral lower-limb paralysis following colonoscopy is extremely rare. Acute limb ischemia due to thromboembolism from abdominal aortic aneurysm (AAA) is a vascular emergency that requires prompt diagnosis and intervention. This is the report of a unique case of acute limb ischemia due to thromboembolism associated with infrarenal AAA following colonoscopy. This case report aims to raise clinical awareness of the potential risk of thromboembolic complications after colonoscopy. Further, this case suggests a potential mechanism in which hemodynamic alterations or periprocedural factors, such as dehydration associated with bowel preparation, may have contributed to thrombus dislodgement and subsequent embolization. PATIENT CONCERNS: A 67-year-old man with acute paraplegia was referred to our emergency department following colonoscopy. DIAGNOSES: The patient was diagnosed with acute thromboembolism associated with an infrarenal AAA, resulting in paraplegia following colonoscopy, as confirmed by computed tomography angiography. INTERVENTIONS: The patient underwent emergent aorto-bifemoral bypass, bilateral lower extremity thrombectomy, and left femoral artery-to-distal superficial femoral artery bypass surgery. OUTCOMES: Although revascularization was technically successful, the patient died of massive reperfusion injury. LESSONS: Acute paraplegia caused by thromboembolism from an infrarenal AAA following colonoscopy is extremely rare but potentially fatal. Awareness of this potential adverse event after colonoscopy is critical to avoid severe outcomes and improve patient prognoses.