J Korean Soc Coloproctol.  2008 Oct;24(5):322-328. 10.3393/jksc.2008.24.5.322.

Treatment of Colon Perforation Associated with Colonoscopy

Affiliations
  • 1Department of Surgery, School of Medicine, Keimyung University, Daegu, Korea. sgbeak@dsmc.or.kr

Abstract

PURPOSE: Recently, non-operative conservative management or laparoscopic repair has been reported for the management of colonic perforation during colonoscopy. However, the preferred management strategy remains controversial. The purpose of the present study is to identify an appropriate strategy for the treatment of colon perforation during colonoscopy.
METHODS
The medical records of patients who developed colon perforation during colonoscopy between May 2003 and November 2007 were retrospectively reviewed. The mechanism and site of perforation, the treatment administered, complications, and clinical outcomes were analyzed.
RESULTS
In total, 16 perforations were evaluated. Of these, 11 developed during diagnostic colonoscopy and 5 during therapeutic colonoscopy. The most frequent perforation site was the sigmoid colon (12), followed by the transverse colon (2), the rectum (1), and unknown site (1). Six patients underwent surgery due to signs of diffuse peritonitis 10 were initially treated conservatively. Among the patients who underwent surgery, four underwent laparoscopic repair and two underwent open repair. Among the patients initially treated conservatively two patients required surgery due to clinical deterioration of peritonitis and rectovaginal fistula. These 2 patients underwent repair with proximal diverting stomas.
CONCLUSIONS
Colon perforation associated with colonoscopy is a rare event, but raises serious complications. Selected patients with colonoscopic perforation may be treated conservatively, but if these patients fail to respond to such treatments, extensive surgical procedures may be warranted.

Keyword

Colon perforation; Colonoscopy

MeSH Terms

Colon
Colon, Sigmoid
Colon, Transverse
Colonoscopy
Humans
Medical Records
Peritonitis
Rectovaginal Fistula
Rectum
Retrospective Studies
Full Text Links
  • JKSC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error