Korean J Gastrointest Endosc.  2005 Apr;30(4):188-193.

Management of Colonic Perforation during Colonoscopic Procedure

Affiliations
  • 1Department of Surgery, University of Dankook College of Medicine, Cheonan, Korea.
  • 2Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Jckim@amc.seoul.kr
  • 3Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
Colonic perforation appears to be the most dangerous complication during colonoscopy. This study was designed to determine the optimal management for this infrequent accident.
METHODS
We reviewed the medical records of 17,510 colonoscopies which were performed during recent one-year period and found eightcolonic perforations (0.05%).
RESULTS
Six perforations (0.04%) related to 16,695 diagnostic procedures, whereas two (0.25%) occurred from therapeutic procedures (p=0.05). Operative measures were applied in six (75.0%) patients showing signs of peritonitis. Five patients received primary closure without diversion, and resection with primary anastomosis was performed in one patient who had underlying tuberculous colitis. In addition, one patient was treated conservatively with bowel rest and intravenous antibiotics. Endoscopic clipping was applied in one patient with rectal perforation. Seven patients recovered uneventfully, and one 69-year-old male patient died of cardiogenic shock after the operation.
CONCLUSIONS
Although colonic perforation occurs infrequently during colonoscopy, it may sometimes results in a fatal outcome. Primary closure without diversion appears to be appropriate in most cases without comorbid colonic disease.

Keyword

Management; Colonoscopy; Colon; Perforation
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