Colonoscopic Perforation During a Diagnostic Colonoscopy

Kim, Jeong Ho; Jeon, Eun Jung; Song, Jun Ho; Lee, Sang Hun; Jung, Jin Hwan; Cheung, Dae Young; Kim, Jin Il; Park, Soo Heon; Kim, Jae Kwang

Abstract

BACKGROUND/AIMS
Colonoscopy is a useful method for detecting colorectal disease, but complications are on the rise due to the increasing number of colonoscopies. The aim of this study was to analyze colon perforations following diagnostic colonoscopies.
METHODS
We performed retrospective reviews of all patients with colonoscopic perforations between January 2000 and June 2010.
RESULTS
Of 25,883 diagnostic colonoscopies performed, seven cases of colon perforations were reported. Among those, five cases had an abdominal operation history; the site of perforation was the sigmoid colon in three cases and the rectum in four cases. The manipulation type was forward viewing in three cases and retroflexion in four cases. The time to diagnosis was immediate in six cases and delayed in one case, and treatment was conservative management in three cases and surgical management in four cases.
CONCLUSIONS
Special attention is required for patients with a previous abdominal operation and retroflexion. Even after perforations occur, favorable outcomes can be obtained by conservative treatment if the patient's condition is stable, the bowel preparation is proper, and there are no signs of peritonitis.