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Iatrogenic colon perforation: endoscopic management or surgery
1Department of Gastroenterology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Clinical Endoscopy
|October 28, 2025
Summary
Iatrogenic colonic perforation from colonoscopy requires prompt recognition. Management involves endoscopic closure for minor defects or surgery for severe cases, guided by international guidelines.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
Background:
- Iatrogenic colonic perforation is a rare but severe complication of colonoscopy.
- Therapeutic colonoscopic procedures carry a higher risk.
- Timely diagnosis and management are critical for patient outcomes.
Purpose of the Study:
- To review current treatment strategies for iatrogenic colonic perforation.
- To summarize management recommendations based on international guidelines.
- To highlight preventative measures and risk factors.
Main Methods:
- Literature review of major international guidelines on colonoscopy complications.
- Analysis of treatment strategies for iatrogenic colonic perforation.
- Synthesis of data on endoscopic and surgical interventions.
Main Results:
- Endoscopic closure (clipping, endoloop, suturing) is effective for selected minor, early-detected perforations with good bowel prep.
- Surgical intervention is necessary for larger, delayed, or complicated perforations with contamination or deterioration.
- Risk factors include advanced age, diverticulosis, and inadequate bowel preparation.
Conclusions:
- Individualized management based on perforation characteristics is essential.
- Endoscopic closure offers a viable option for specific cases.
- Preventative strategies focusing on risk factor identification and optimal bowel preparation are crucial.
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