Colonoscopy after recent PE

72-year-old man for gastroscopy and colonoscopy


  • Surveillance colonoscopy for previous benign polyps
  • Gastroscopy for chronic GORD symptoms
  • BMI 57
  • NIDDM, good control
  • PAF, on Apixaban
  • Pulmonary Hypertension, routine echo in 2017


  • Recent Bilateral PE’s (April 2021) with significant clot burden
  • Admission with sepsis and AKI 2 months previously and DOAC ceased
  • No investigations for OSA; STOPBANG 8 and Epworth Sleepiness Score 12
  • Not known to respiratory physician and no follow-up in place from hospital admission


Should procedure be postponed?

  • Yes. Elective procedure. No red flags.
  • Surgical team in agreement.
  • Postpone until 6 months post PE.
  • Postponement of 3 months is usually adequate. A longer timeframe was selected in this patient due to the severity of his disease and complex comorbidities.


  • Referral to respiratory physician; significant clot burden, should he have repeat imaging before interruption of anticoagulation?
  • Clinical suspicion of OSA (and possibly OHS) given multiple risk factors, ESS, and long-standing pulmonary hypertension.
  • Plan to discuss with respiratory physician


  • Postpone for at least 3 months
  • Repeat echocardiogram
  • Referral to respiratory team