Non surgical management of colonoscopic bowel perforation

Five patients (four males, and one female, median age of 60 years) with colonoscopy-related bowel perforations were managed between January 1993 and June 1994. One patient had a difficult colonoscopy whereas four patients had polypectomies or biopsies. Abdominal pain was the main presenting symptom at a median of 3 h (range 2 to 12 h) following colonoscopy. Four patients demonstrated free pneumoperitoneum whilst one showed a pelvic abscess. Following non-surgical management, abdominal signs diminished after 24 to 48 h and disappeared by the fifth day in all patients. All patients were discharged well at day seven (range 5 to 9 days) and have remained well at 12 months of follow-up (range 3 to 18 months).