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[Colonic perforation in patients undergoing colonoscopy].

R Sivelli1, P Del Rio, R Dalla Valle

  • 1Istituto di Clinica Chirurgica Generale e dei Trapianti d'Organo, Università di Parma, Via Gramsci, 14, 43100 Parma.

Chirurgia Italiana
|July 17, 2001
PubMed
Summary

Colonic perforations from colonoscopy are rare but serious. Primary repair is best for uncomplicated cases, while non-operative management suits patients without peritoneal irritation, improving outcomes for iatrogenic colorectal injuries.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Medical Device Complications

Context:

  • Iatrogenic colorectal perforations are infrequent complications of colonoscopy.
  • Understanding their incidence, presentation, and management is crucial for patient care.
  • This study reviews cases over a 17-year period.

Purpose:

  • To determine the incidence of colon perforations during colonoscopy.
  • To describe the clinical presentation of these iatrogenic injuries.
  • To evaluate medical and surgical treatment outcomes.

Summary:

  • Eight patients with iatrogenic colorectal perforations were analyzed.
  • The median age was 68.3 years.
  • Seven patients underwent emergency laparotomy; one received non-operative management.

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  • A single postoperative death occurred.
  • Primary repair is recommended for cases without significant contamination.
  • Non-operative management is suitable for patients without peritoneal signs.

    • Impact:

    • Highlights the importance of prompt diagnosis and appropriate management of colonoscopic perforations.
    • Informs surgical decision-making, favoring primary repair when feasible.
    • Emphasizes the role of non-operative strategies in select patients.
    • Contributes to improving safety protocols for colonoscopy procedures.