[Treatment of colonoscopic perforations]

Perforations of the large intestine during colonoscopy are relatively rare but serious complications of this routine examination. In recent years the approach to their treatment has changed in favour of more conservative procedures, in particular in perforations which occurred during polypectomy. In the authors' department during the last five years 12 patients were treated with perforations which occurred during colonoscopy. Ten patients were operated on (4x suture of the perforation, 2x primary anastomosis, 5x derivation of the gut), two patients were successfully treated by conservative methods without surgery. Fifty per cent of the operated patients had complications. Nobody died. The mean period of hospitalization was 27.9 days in the operated patients and 4.5 days in those who did not undergo surgery. From the results ensues that a differentiated approach must be used in perforations and in indicated cases (perforations after polypectomy, satisfactory condition of the patient, minimal assumed contamination of the abdominal cavity) a conservative method can be used. Correct surgical tactics reduce the morbidity and mortality.