Pneumatic perforation of the colon during colonoscopy. Is the hypermobile right colon a risk factor?

Perforation of the colon by pneumatic injury during colonoscopy is a rare complication. Intraoperative observations of a patient who developed massive cecal distention, pneumatosis coli and severe pneumoperitoneum during colonoscopy suggest that an isolated, air-trapping colonic segment is a factor in the mechanism of such injury. The possibility that a poorly fixed, hypermobile cecum and right colon predispose to such injury by air insufflation during colonoscopy is discussed.