Exploratory laparoscopy for perforation following colonoscopy

Colonoscopy is being increasingly used for the diagnosis and therapy of colonic diseases. Bleeding and perforation are two major complications. The management of patients with perforation is undergoing evolution. There is evidence to support conservative management in selected patients with perforation without clinical signs of peritonitis. There is, however, a subset of patients with perforation where a considerable doubt exists about the choice between surgical and conservative management. We report one such patient, a 50-year-old woman with free air under the diaphragm and peritoneal signs following a therapeutic colonoscopy in whom an exploratory laparoscopy was performed. Exploratory laparoscopy is proposed for such patients when there is a question in choosing between surgical and conservative management.