Postendoscopic Mucosal Injury Syndrome Mimicking Postpolypectomy Electrocoagulation Syndrome After Colonoscopic Biopsy

This case report describes a rare, severe presentation of postendoscopic mucosal injury syndrome mimicking postpolypectomy electrocoagulation syndrome (PPECS) in a 40-year-old woman. After an uncomplicated colonoscopy with mucosal biopsies, the patient developed septic shock with hemodynamic instability, requiring intensive care. Computed tomography findings raised suspicion for colonic perforation, prompting an exploratory laparotomy. Surgical exploration, however, revealed no perforation but significant serosal inflammation and reactive lymphadenopathy consistent with a PPECS-like inflammatory process. This case highlights the diagnostic challenge of distinguishing severe PPECS-like presentations from true perforation and underscores the potential for life-threatening complications even in the absence of documented electrocautery or polypectomy.