BACKGROUND/AIMS: Colonoscopy is the principal method for diagnosis, treatment, and follow up of colorectal disease. The study aimed to assess the incidence, clinical features, and management of colonoscopic perforations at a local general hospital. METHODS: A retrospective review of patient record was performed for all patients with iatrogenic colonic perforation after sigmoidoscopy and colonoscopy between 1997 and 2007. RESULTS: In the 10-year period, 16,388 colonoscopic and sigmoidscopic procedure were performed. All 10 cases of procedure related colonic perforation were developed. Perforation occurred in 9 cases during therapeutic procedure; 5 cases due to polypectomy and 4 cases due to endoscopic submucosal dissection. Perforation occurred in one case during diagnostic procedure. CONCLUSIONS: Therapeutic procedure is a clear risk factor of colonic perforation. When colonic perforation occurs, we should be able to make early diagnosis. Early diagnosis can lead to a good treatment and can produce good prognosis with short hospital days.
Colonic Diseases/diagnosis/epidemiology/*etiology ; Colonoscopy/*adverse effects ; Humans ; *Iatrogenic Disease/epidemiology ; Incidence ; Intestinal Perforation/*diagnosis/epidemiology/*etiology ; Prognosis ; Retrospective Studies ; Risk Factors ; Sigmoidoscopy/adverse effects

OBJECTIVETo evaluate the risk factors affecting the early postoperative outcomes in patients with small bowel obstruction.

METHODSClinical data of 193 patients with small bowel obstruction undergone operation were analyzed retrospectively. A range of factors were investigated to estimate postoperative outcome, including gender, age, comorbidities, etiology of obstruction, presence of strangulated bowel (viable or nonviable), leukocyte count, temperature, and heart rate. Logistic regression analysis was used to study the prognostic value of each significant variable in terms of postoperation.

RESULTSThe major causes of small bowel obstruction were adhesion and hernia, contributing 38.9% and 37.8% of all cases, respectively. Strangulation occurred in 42.0% and caused nonviable bowel in 23.3% of obstructing episodes. Elderly (>or=70 years), diabetes, malignant tumors WBC >15x10(9)/L were independent significant factors associated with bowel strangulation. The overall complication rate was 16.1%, the 30-day mortality was 4.1%, and the median postoperative hospital stay was 13 days. Age >or=70 years and bowel resection were significantly associated with postoperative complications in the univariate analysis. Only elderly and malignant obstruction were significantly associated with operative mortality in multivariate logistic regression.

CONCLUSIONSSurgery for small bowel obstruction is still associated with significant mortality and morbidity. Elderly is significantly associated with an increased incidence of strangulation, operative mortality, and complications.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Incidence ; Intestinal Obstruction ; diagnosis ; etiology ; surgery ; Intestinal Perforation ; epidemiology ; Intestine, Small ; surgery ; Logistic Models ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Young Adult