Colon perforation during colonoscopy: surgical versus conservative management.
A survey of endoscopy units in the West Midlands, UK, was undertaken to ascertain the management of colonic perforation during colonoscopy. Fifteen perforations were reported from a total of 17,500 colonoscopies performed in 14 units (a rate of 0.09 per cent). In seven patients the diagnosis was suspected or diagnosed immediately and in the remaining eight 2-72 h later. Four patients with associated pathology (carcinoma, Crohn's disease, ulcerative colitis and a polyp) had resection and primary anastomosis. Seven patients had a simple oversew, four of these having had a delayed diagnosis. In four cases the site of perforation was not identified, but only one patient had conservative treatment. Three patients had drainage and a defunctioning colostomy. There was no significant morbidity following treatment. It is recommended that patients who have had a good bowel preparation should be treated conservatively unless there is a large perforation or an underlying carcinoma.
Hall
C
C
Academic Department of Surgery, Dudley Road Hospital, Birmingham, UK.
Dorricott
N J
NJ
Donovan
I A
IA
Neoptolemos
J P
JP
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D003113:Colonoscopy / Q000009:adverse effects*; D003125:Colostomy; D004322:Drainage; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D007431:Intraoperative Complications / Q000628:therapy; D008297:Male; D008875:Middle Aged