[Incidence of iatrogenic perforation during colonoscopy and their treatment in a university hospital].
BACKGROUND
Colon perforation is a fairly uncommon, but serious, complication during endoscopy of the lower gastrointestinal tract. Treatment is controversial, although surgery is used in the majority of cases. The aims of this study were to determine the incidence of perforations due to colonoscopy in our hospital and to find out the results of the treatment options used.


METHODS
Retrospective study of perforations caused by colonoscopy between January 2004 and October 2008. The variables analysed were: demographic characteristics, colonoscopy indication, clinical signs and symptoms, diagnostic tests used, time between perforation and the diagnosis, treatment type, hospital stay and complications.


RESULTS
A total of 13,493 colonoscopies were performed during the study period. A perforation of the colon was found in 13 (0.1%) patients. Nine perforations occurred whilst performing a diagnostic colonoscopy (0.08%) and the remaining 4 after a therapeutic colonoscope (0.16%). In 10 of the cases the diagnosis was made within the first 12h, and in 5 of these the perforation was identified during the procedure itself. The most common location was the sigmoid, in 7 cases. Surgical treatment was carried out on 11 patients, and in the other two it was resolved by conservative treatment. The most used surgical technique was simple suture followed by resection with anastomosis. One patient died due to intra-abdominal sepsis.


CONCLUSIONS
Perforations caused by colonoscopy are rare, but serious, complications. The majority of these patients required surgical treatment, with conservative treatment being reserved for selected patients.
Alonso
Sandra
S
Unidad de Cirugía Colorrectal, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario del Mar, Barcelona, España. 94982@imas.imim.es
Dorcaratto
Dimitri
D
Pera
Miguel
M
Seoane
Agustín
A
Dedeu
Josep M
JM
Pascual
Marta
M
José Gil
M
M
Courtier
Ricard
R
Bory
Felipe
F
Grande
Luis
L
D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000293:injuries* / Q000601:surgery; D003113:Colonoscopy; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D015994:Incidence; D007416:Intestinal Perforation / Q000453:epidemiology* / Q000601:surgery; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies