Incidence and management of colonoscopic perforations in Korea.
OBJECTIVE
Despite the low incidence of perforation after endoscopic procedures in the colon, the increasing use of these procedures is likely to cause a commensurate increase in such problems. This study was undertaken to determine the incidence of iatrogenic perforation of the colon, to define clinical characteristics, and to assess the management of these complications.


METHODS
A retrospective review of the medical records was performed for all patients with iatrogenic colon perforations after endoscopy between January 2000 and June 2007.


RESULTS
Over this 7-year study period, a total of 20,660 sigmoidoscopies, 17,102 colonoscopies, and 6,772 therapeutic procedures were performed, and 53 (0.12%) perforations were determined to be related to endoscopy. A diagnostic procedure was undertaken in 26 of these 53 perforation cases (perforation rate, 0.07%; 1 per 1,452 procedures), and a therapeutic procedure in the remaining 27 (perforation rate, 0.40%; 1 per 251 procedures). Nineteen patients (36%) were treated conservatively, and the remaining 34 (64%) required surgical management. Endoscopic clipping was performed in 9 patients, and conservative treatment was possible in 7 patients with successful closure. No procedure-related mortality occurred.


CONCLUSIONS
Endoscopic repair of iatrogenic colon perforations with clips could reduce immediate operative intervention rates.
Kang
Hae Yeon
HY
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Kang
Hyoun Woo
HW
Kim
Sang Gyun
SG
Kim
Joo Sung
JS
Park
Kyu-Joo
KJ
Jung
Hyun Chae
HC
Song
In Sung
IS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000009:adverse effects*; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D007416:Intestinal Perforation / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012812:Sigmoidoscopy / Q000009:adverse effects; D013525:Surgical Instruments