Incidence and management of colonoscopic perforations: 8 years' experience.
OBJECTIVE
To review the experience of a major medical teaching center with diagnostic and therapeutic colonoscopies and to assess the incidence and management of related colonic perforations.


METHODS
All colonoscopies performed between January 1994 and December 2001 were studied. Data on patients, colonoscopic reports and procedure-related complications were collected from the departmental computerized database. The medical records of the patients with post procedural colonic perforation were reviewed.


RESULTS
A total of 120067 colonoscopies were performed during the 8 years of the study. Seven colonoscopic perforations (4 females, 3 males) were diagnosed (0.058%). Five occurred during diagnostic and two during therapeutic colonoscopy. Six were suspected during or immediately after colonoscopy. All except one had signs of diffuse tenderness and underwent immediate operation with primary repair done in 4 patients. No deaths were reported.


CONCLUSIONS
Perforation rate during colonoscopy is low. Nevertheless, it is a serious complication and its early recognition and treatment are essential to optimize outcome. In patients with diffuse peritonitis early operative intervention makes primary repair a safe option.
Tulchinsky
Hagit
H
Department of Surgery B, Sourasky Medical Center, 6 Veizman St., Tel Aviv 64239, Israel. hagitt@tasmc.health.gov.il
Madhala-Givon
Osnat
O
Wasserberg
Nir
N
Lelcuk
Shlomo
S
Niv
Yaron
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000293:injuries / Q000601:surgery; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome