[Diagnosis and management of colon perforation after colonoscopy].
BACKGROUND
Colon perforation is an uncommon but feared complication of colonoscopy. The treatment is usually surgical but occasionally it does not require an operation.


OBJECTIVE
To report our experience in the diagnosis and management of colon perforation after colonoscopy.


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.
García
Eduardo
E
Departamento de Cirugía Digestiva, Pontificia Universidad Católica de Chile, Chile. eduagon1972@yahoo.es
López-Köstner
Francisco
F
Rollan
Antonio
A
Muñoz
Rodrigo
R
Contardo
María José
MJ
Bellolio
Felipe
F
García
Ximena
X
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003106:Colon / Q000000981:diagnostic imaging / Q000293:injuries*; D003113:Colonoscopy / Q000009:adverse effects*; D003125:Colostomy; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome