title: The indications for nonsurgical management in patients with colorectal perforation after colonoscopy.
abstract: Recently, the risk of colonic perforation has been increasing with the increased frequency of advanced therapeutic endoscopy. However, guidelines for the management of colon perforations after colonoscopy have not been established. This study aimed to evaluate the indications for nonsurgical  management. This study was conducted as a case-control study with 22 patients who were managed for colorectal perforations after colonoscopy from June 2004 to July 2009. Colonoscopy was performed in 12 patients (54.4%) for diagnostic purposes and 10 (45.5%) for therapeutic reasons.  The most common site of perforation was the sigmoid colon (77.3%). Five patients underwent nonsurgical treatment, and 17 patients received surgical treatment. The duration of hospital stay did not differ significantly between the two groups. Abdominal pain and fever were significantly more  commonly encountered in the surgical management group (P = 0.043 and 0.011, respectively). All of the patients who were suitable for nonsurgical treatment were diagnosed within 24 hours and received bowel preparation before the colonoscopy. The nonsurgical treatment of colonic perforation  after colonoscopy could be feasible in afebrile patients with less severe abdominal pain. Moreover, cases that were diagnosed within 24 hours and received bowel preparation before colonoscopy were associated with better outcomes.
authors.affiliation: Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Dae Youn
authors.initials: DY
authors.lastname: Won
authors.forename: In Kyu
authors.initials: IK
authors.lastname: Lee
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Lee
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Cheung
authors.forename: Seung Bong
authors.initials: SB
authors.lastname: Choi
authors.forename: Hun
authors.initials: H
authors.lastname: Jung
authors.forename: Seung Taek
authors.initials: ST
authors.lastname: Oh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000293:injuries*; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003113:Colonoscopy / Q000009:adverse effects*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies