Iatrogenic colon perforation: endoscopic management or surgery

Iatrogenic colonic perforation is a rare but serious complication of colonoscopy, particularly during therapeutic procedures. Prompt recognition and individualized management are essential to prevent adverse outcomes. This review summarizes current treatment strategies based on major international guidelines. Endoscopic closure is recommended for selected cases involving minor defects, early detection, and adequate bowel preparation. Techniques such as clipping, endoloop application, and suturing have demonstrated favorable success rates. Surgical intervention is crucial for larger, delayed, or complicated perforations, particularly those associated with significant contamination or clinical deterioration. Recognizing risk factors such as age, diverticulosis, and inadequate bowel preparation can help prevent this complication.