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Postpolypectomy electrocoagulation syndrome

Brooks D Cash, MD, FACG, AGAF, FACP
Section Editor
John R Saltzman, MD, FACP, FACG, FASGE, AGAF
Deputy Editor
Kristen M Robson, MD, MBA, FACG


Postpolypectomy electrocoagulation syndrome (also known as postpolypectomy syndrome and transmural burn syndrome) refers to the development of abdominal pain, fever, leukocytosis, and peritoneal inflammation in the absence of frank perforation after polypectomy with electrocoagulation. Recognition of postpolypectomy syndrome is important to avoid unnecessary exploratory laparotomy since it resolves with conservative treatment in the majority of patients.


The reported incidence of postpolypectomy electrocoagulation syndrome varies widely, ranging from 0.3 out of 10,000 (0.003 percent) to 50 out of 10,000 (0.5 percent) colonoscopies [1-8].

Postpolypectomy electrocoagulation syndrome was reported in 6 patients out of 16,318 colonoscopies (0.03 percent) performed between 1994 and 2002 in a large integrated health system [2].

Another series described three types of cautery injury in 4784 consecutive polypectomies [3]. Two patients had frank perforation, 5 had "mini-perforation," and 24 (0.5 percent) developed postpolypectomy electrocoagulation syndrome.

A study on 2106 polypectomies in 1252 patients reported that 3 patients (0.14 percent) were admitted to the hospital for symptoms consistent with this syndrome [4]. All resolved with medical therapy.

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Literature review current through: Nov 2017. | This topic last updated: Nov 24, 2015.
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