Endoscopic treatment of delayed colon perforation: the enteroscopy overtube approach.
OBJECTIVE
Delayed perforation is a rare complication of therapeutic colonoscopy, and it is severe and sometimes lethal. This paper reports on a new minimally invasive method for the treatment of delayed colonic perforation.


METHODS
Three patients with delayed colonic perforation underwent the therapy, which involved three steps: (1) closure with endoclips and loop, (2) overtube placement, and (3) antibiotic wash through a nasobiliary tube.


RESULTS
The procedure was successful in all three patients and no recurrence was observed during 5 - 41 months of follow-up.


CONCLUSIONS
Although this study involved only a small number of patients and no control arm, the method involving an overtube appears to be a feasible and effective endoscopic treatment for delayed colonic perforation.
Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Yu-Feng
YF
Xiao
Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Jan-Ying
JY
Bai
Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Jin
J
Yu
Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Xian-Long
XL
Lin
Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Xiao-Yan
XY
Zhao
Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Shi-Ming
SM
Yang
Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Chao-Qiang
CQ
Fan
D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage; D003113:Colonoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004210:Dissection / Q000009:adverse effects; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D007416:Intestinal Perforation / Q000209:etiology / Q000628:therapy*; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D007507:Therapeutic Irrigation; D013997:Time Factors
D000890:Anti-Infective Agents; D008795:Metronidazole