Management of Colonic Perforation during Colonoscopic Procedure.
- Author:
Hwan NAMGUNG
1
;
Moon Kyung CHO
;
Kang Hong LEE
;
Seung Jae MYUNG
;
Suk Kyun YANG
;
Chang Sik YU
;
Hee Cheol KIM
;
Jin Cheon KIM
Author Information
1. Department of Surgery, University of Dankook College of Medicine, Cheonan, Korea.
- Publication Type:Original Article
- Keywords:
Management;
Colonoscopy;
Colon;
Perforation
- MeSH:
Aged;
Anti-Bacterial Agents;
Colitis;
Colon*;
Colonic Diseases;
Colonoscopy;
Fatal Outcome;
Humans;
Male;
Medical Records;
Peritonitis;
Shock, Cardiogenic
- From:Korean Journal of Gastrointestinal Endoscopy
2005;30(4):188-193
- CountryRepublic of Korea
- Language:Korean
-
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.
