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Revista médica de Chile

Print version ISSN 0034-9887

Abstract

GARCIA, Eduardo et al. Diagnosis and management of colon perforation after colonoscopy. Rev. méd. Chile [online]. 2008, vol.136, n.3, pp.310-316. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872008000300005.

Background: Colon perforation is an uncommon but feared complication of colonoscopy. The treatment is usually surgical but occasionally it does not require an operation. Aim: To report our experience in the diagnosis and management of colon perforation after colonoscopy. Material and methods: Retrospective review of the database of 11,720 colonoscopies. The medical records of those patients that had a perforation were reviewed. Results: Twelve perforations in patients aged 26 to 92 years (six women), were identified with a global perforation rate of 0.1%. Five occurred during diagnostic and seven during therapeutic procedures. All perforations were confirmed by a plain X ray or CT scan of the abdomen. Four patients, without signs of initial diffuse peritoneal irritation, were medically treated. One of these, finally required surgery. Among operated patients, a primary suture was done in five, a primary excision without colostomy in three and a Hartmann procedure due to a severe peritoneal contamination in one. No patient died. Conclusions: There is a higher risk of colon perforation during therapeutic colonoscopies. Selected cases may be safely treated without surgery

Keywords : Colonoscopy; Colostomy; Intestinal perforation.

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