title: Endoclip closure of a large colonic perforation following colonoscopic leiomyoma excision.
abstract: OBJECTIVE
  Endoscopic removal of large colonic submucosal lesions can lead to a higher risk of perforation. Although not as common following diagnostic and therapeutic colonoscopy, it does occur more often following therapeutic colonoscopy. We present a case of a large submucosal mass excised endoscopically, resulting in a large perforation that was closed using endoclips. While endoclips are typically used for smaller perforations, we have found that they can be used safely on a larger defect.
  
  
  METHODS
  A 68-y-old woman presented with a 2.9-cm benign submucosal mass found in the hepatic flexure. It was removed via endoscopic polypectomy, leaving a perforation of 3cm x 3cm. The perforation was closed with endoscopic clips.
  
  
  RESULTS
  Histology of the specimen showed clear margins. At 4-wk follow-up, the patient had no complications. A colonoscopy at 6-mo follow-up showed only a scar at the procedure site with no complaints.
  
  
  CONCLUSIONS
  Large iatrogenic colonic perforations can be managed successfully using endoclips, particularly in a prepped colon.
authors.affiliation: Division of Colon and Rectal Surgery, University of Illinois Medical Center, Chicago, IL 60612, USA. vamsivelchuru@gmail.com
authors.forename: Vamsi R
authors.initials: VR
authors.lastname: Velchuru
authors.forename: Marek
authors.initials: M
authors.lastname: Zawadzki
authors.forename: Amy L
authors.initials: AL
authors.lastname: Levin
authors.forename: Christine M
authors.initials: CM
authors.lastname: Bouchard
authors.forename: Slawomir
authors.initials: S
authors.lastname: Marecik
authors.forename: Leela M
authors.initials: LM
authors.lastname: Prasad
authors.forename: John J
authors.initials: JJ
authors.lastname: Park
mesh_terms: D000368:Aged; D003108:Colonic Diseases / Q000209:etiology* / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery*; D007889:Leiomyoma / Q000601:surgery*; D017154:Stromal Cells / Q000473:pathology