Endoscopic closure of a large iatrogenic rectal perforation using endoloop/clips technique

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Techniques

Background:

• Retroflexion of the colonoscope provides enhanced visualization of the rectal vault compared to standard forward-viewing endoscopy.
• This technique is generally safe, well-tolerated, and associated with minimal complications in routine practice.

Observation:

• A large oval rectal perforation occurred unexpectedly in a healthy rectum during a follow-up colonoscopy utilizing retroflexion.
• The perforation was immediately addressed using the endoloop/clips closure technique during the same endoscopic procedure.

Findings:

• The patient experienced an uneventful recovery, with discharge after 5 days.
• Two-month follow-up endoscopy confirmed complete healing of the rectal perforation without any residual symptoms or complications.

Implications:

• This case highlights a rare but manageable complication of colonoscope retroflexion.
• The successful application of the endoloop/clips technique demonstrates its efficacy in managing iatrogenic rectal perforations.
• Endoscopic management of such perforations can lead to favorable outcomes, avoiding the need for surgical intervention.