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Colon perforation during colonoscopy: surgical versus conservative management
C Hall1, N J Dorricott, I A Donovan
1Academic Department of Surgery, Dudley Road Hospital, Birmingham, UK.
The British Journal of Surgery
|May 1, 1991
Summary
Colonoscopy can cause colonic perforation, occurring in 0.09% of procedures. Most perforations are managed successfully with oversewing or resection, with conservative treatment recommended for those with good bowel preparation.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Colonoscopy is a common procedure for colorectal examination.
- Colonic perforation is a rare but serious complication of colonoscopy.
Purpose of the Study:
- To survey the management of colonic perforation during colonoscopy in the West Midlands, UK.
- To determine the incidence and outcomes of colonic perforation following colonoscopy.
Main Methods:
- A survey of 14 endoscopy units in the West Midlands, UK.
- Data collected on 17,500 colonoscopies, identifying 15 cases of colonic perforation.
- Analysis of diagnostic timing, surgical management, and patient outcomes.
Main Results:
- The rate of colonic perforation was 0.09% (15/17,500).
- Diagnosis was immediate in 7 patients and delayed (2-72 hours) in 8.
- Management included resection with anastomosis (4 patients), simple oversew (7 patients), and drainage with colostomy (3 patients).
- No significant morbidity was reported following treatment.
Conclusions:
- Colonic perforation during colonoscopy is infrequent.
- Successful management is achievable through various surgical interventions.
- Conservative management is recommended for perforations in patients with good bowel preparation, unless complicated by large defects or underlying malignancy.