[Treatment strategy in iatrogenic perforation of the large intestine]

Iatrogenic perforation of the colon is a rare but feared complication of coloscopy with an incidence of up to 0.3%. During a period of 12 years we saw 14 perforations of this kind. The therapeutic approach varies with the state of peritonitis and type of perforation. Conservative primary therapy should only be chosen in rare cases. Classic operative therapy ranges from simple suturing to partial resection of the colon, in cases including even formation of a colostomy. In case of diffuse peritonitis discontinuity resection following Hartmann is still recognized as a secure procedure. Lethality of 7.1% in our own patients confirms the effectivity of conventional operating methods.