[Colonic perforation after colonoscopy: our experience]

The authors describe 6 cases of perforation during colonoscopy, occurring over the period from 1981 to 2001, out of a total of 7358 endoscopic examinations performed. Five of these perforations were found as complications of operative colonoscopy. In one case the endoscopic view of the omentum immediately revealed the perforation. Four patients underwent surgical treatment and in two cases medical therapy was implemented. In agreement with the literature, the authors stress that the management of iatrogenic colon perforations is quite difficult and depends upon the clinical features. While conservative treatment is indicated in minimal perforations in patients in good general condition with no signs of peritoneal irritation, surgery must be performed in all uncertain situations. A delay in performing surgical treatment may sometimes prove fatal.