title: Colonoscopic perforations in inflammatory bowel disease: a retrospective study in a French referral centre.
abstract: BACKGROUND
  Whether inflammatory bowel disease patients are at increased risk of colonoscopic perforations remains controversial. Aim of this study was to investigate whether these patients are at increased risk of perforations.
  
  
  METHODS
  Electronic charts of all patients enrolled in the Nancy IBD cohort (1999-2012) were reviewed. All non-inflammatory bowel disease patients who underwent colonoscopy (1999-2012) were used as controls.
  
  
  RESULTS
  Of 17,992 colonoscopies, 2375 (13.2%) were performed for inflammatory bowel disease: 1547 for Crohn's disease and 828 for ulcerative colitis. Four IBD patients (0.168%) experienced perforation. Perforation occurred in the sigmoid colon (n = 3) and right colon (n = 1) during disease monitoring or colonic stenosis dilatation. Three patients underwent surgery (2 stomas and no death). Colonoscopic perforation occurred in 16/15,617 controls (0.102%): colonic cancer diagnosis (n = 5, 31.3%) or dilatation (n = 2, 12.5%), polypectomy (n = 5, 31.3%) or mucosectomy (n = 1, 6.3%), and follow-up after diverticulitis (n = 2, 12.5%). Perforation rate was not different between IBD and controls (p = 0.57). Perforations occurred in the sigmoid colon (n = 10, 62.5%), the right colon (n = 4, 25%) and the rectum (n = 2, 12.5%). Twelve controls underwent surgery (9 stomas and one death).
  
  
  CONCLUSIONS
  In this referral centre-based cohort, inflammatory bowel disease patients were not at increased risk of colonoscopic perforation compared to non-IBD controls.
authors.affiliation: Department of Hepato-Gastroenterology, University Hospital Estaing of Clermont-Ferrand, Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Buisson
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Chevaux
authors.forename: Hervé
authors.initials: H
authors.lastname: Hudziak
authors.forename: Laurent
authors.initials: L
authors.lastname: Bresler
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Bigard
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications*; D003106:Colon / Q000293:injuries; D012809:Colon, Sigmoid / Q000293:injuries; D003108:Colonic Diseases / Q000209:etiology*; D003113:Colonoscopy / Q000009:adverse effects*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D005602:France; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult