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Related Experiment Videos

Colonoscopic perforations: a retrospective review.

Corey W Iqbal1, Yun Shin Chun, David R Farley

  • 1Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|December 8, 2005
PubMed
Summary

Colonoscopy is increasingly common, leading to more iatrogenic colonic perforations. While nonoperative management is possible for patients without peritonitis, prompt surgery improves outcomes for colon perforation.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Medical Complications

Background:

  • Colonic perforation is a known complication of colonoscopy.
  • Increased colonoscopy use has led to a higher incidence of iatrogenic injuries.

Purpose of the Study:

  • To examine trends in colonoscopic perforations over a 7-year period.
  • To assess management strategies and patient prognosis following colonoscopic perforation.

Main Methods:

  • Retrospective analysis of 78,702 colonoscopies performed between 1994 and 2000.
  • Review of medical records for patients treated for colonic perforation at the institution.

Main Results:

  • The perforation rate was 0.084% (1 per 1192 procedures).

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  • 62 patients underwent laparotomy, while 10 were managed nonoperatively.
  • Factors predicting poor outcomes included delayed diagnosis, extensive peritoneal contamination, and anticoagulant use.

    • Conclusions:

    • Colonoscopic perforation remains a significant complication, with rates around 0.08%.
    • Nonoperative management is a viable option for select patients without peritonitis.
    • Expedient surgical intervention appears to improve patient recovery from colonic perforation.