[Large iatrogenic colonic perforation treated by endoscopic suturing].

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Surgery

Background:

• Colonic perforation is a severe complication of colonoscopy, with surgery as the traditional treatment.
• Interventional endoscopy, including endoscopic suturing, has emerged as a potential alternative.
• Previous reports focused on smaller perforations (<10mm).

Observation:

• This study reports on two cases of colonic perforations, both measuring at least 10mm.
• The perforations occurred during diagnostic colonoscopy (sigmoid diverticulum) and endoscopic mucosal resection (ascending colon).
• Both perforations were successfully treated using endoscopic suturing with hemoclips.

Findings:

• Endoscopic hemoclip suturing is effective for managing larger colonic perforations (≥10mm).
• This technique provides a minimally invasive treatment option, potentially avoiding surgery.
• Successful closure was achieved in both reported cases, regardless of perforation etiology.

Implications:

• Endoscopic suturing may expand the non-operative management options for colonic perforations.
• This approach could reduce the need for surgical intervention, lowering patient morbidity.
• Further research is warranted to establish the safety and efficacy of endoscopic suturing for larger perforations.