SURGICAL textbooks emphasize the need for care in the electrosurgical treatment of adenomatous polypi of the upper rectum and sigmoid colon, particularly when the lesion is on the anterior rectal wall or above the peritoneal reflection. In these areas, through-and-through coagulation of the colonic wall may lead to (1) injury to the vagina, in the female, or to the seminal vesicles or bladder, in the male; (2) delayed hemorrhage, when separation of too deep a slough uncovers a blood vessel of large size; (3) intestinal obstruction due to adhesion of a loop of small bowel to serosal exudate over a coagulated area,1 or (4) peritonitis, when the necrotic area borders on peritoneum.
The true incidence of such complications is not known, and it is reasonable to assume that the occasional fatality, with the unfavorable stigma it attaches to the operating surgeon, is not always reported in the literature.
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