Post-Polypectomy Syndrome (PPS): A Case Report

  • Mohamed Alshmandi Tallaght University Hospital
  • Haider Ali Tariq Butt Department of Medicine, Midland Regional Hospital of Portlaoise, Portlaoise, Ireland
  • Mahtab Sheikh Department of Medicine, Midland Regional Hospital of Portlaoise, Portlaoise, Ireland
  • Khaled Baghdadi Department of Medicine, Midland Regional Hospital of Portlaoise, Portlaoise, Ireland.
DOI: https://doi.org/10.5937/scriptamed57-61403
Keywords: Colonoscopy, Endoscopic mucosal resection, Syndrome, Postoperative complications, Resection

Abstract


A 51-year-old female with unremarkable medical history developed right iliac fossa pain and fever one day post-polypectomy procedure. Management involved hospital admission for monitoring, supportive care with intravenous fluids and “nothing by mouth (NPO)”, broad-spectrum intravenous antibiotics and analgesia. The case here points the critical importance of post-polypectomy syndrome (PPS) occurring after cold endoscopic mucosal resection (EMR). Clinicians should consider PPS in patients admitted with fever, abdominal pain and raised inflammatory markers within a week of polypectomy, regardless of the technique used. Prompt CT imaging is crucial for accurate diagnosis and to exclude perforation.

References

Plunkett RD, Matiwala N, Schroeder M, Qureshi A, Presti M. Postpolypectomy syndrome without the use of hot snare. Cureus. 2025 Feb 14;17(2):e79010. doi: 10.7759/cureus.79010.

Hirasawa K, Sato C, Makazu M, Kaneko H, Kobayashi R, Kokawa A, et al. Coagulation syndrome: Delayed perforation after colorectal endoscopic treatments. World J Gastrointest Endosc. 2015 Sep 10;7(12):1055-61. doi: 10.4253/wjge.v7.i12.1055.

Arimoto J, Higurashi T, Kato S, Fuyuki A, Ohkubo H, Nonaka T, et al. Risk factors for post-colorectal endoscopic submucosal dissection (ESD) coagulation syndrome: a multicenter, prospective, observational study. Endosc Int Open. 2018 Mar;6(3):E342-E349. doi: 10.1055/s-0044-101451.

Yamashina T, Takeuchi Y, Uedo N, Hamada K, Aoi K, Yamasaki Y, et al. Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm. J Gastroenterol Hepatol 2016;31:615–20. doi: 10.1111/jgh.13052.

Nakajima T, Saito Y, Tanaka S, Iishi H, Kudo S, Ikematsu H, et al. Current status of endoscopic resection strategy for large, early colorectal neoplasia in Japan. Surg Endosc 2013;27:3262–70. doi: 10.1007/s00464-013-2903-x.

Jehangir A, Bennett KM, Rettew AC, Fadahunsi O, Shaikh B, Donato A. Post-polypectomy electrocoagulation syndrome: a rare cause of acute abdominal pain. J Community Hosp Intern Med Perspect. 2015 Oct 19;5(5):29147. doi: 10.3402/jchimp.v5.29147.

Benson BC, Myers JJ, Laczek JT. Postpolypectomy electrocoagulation syndrome: a mimicker of colonic perforation. Case Rep Emerg Med. 2013;2013:687931. doi: 10.1155/2013/687931.

Sethi A, Song LM. Adverse events related to colonic endoscopic mucosal resection and polypectomy. Gastrointest Endosc Clin N Am. 2015 Jan;25(1):55-69. doi: 10.1016/j.giec.2014.09.007.

Published
2026/02/28
Issue
Vol. 57 No. 1 (2026): Jan-Feb
Section
Case report
Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).