Iatrogenic colonic perforation by colonoscopy: outcomes of surgery at a single center
Original research work
Edgaras Smolskas
Audrius Dulskas
Inga Kildušienė
Eugenijus Stratilatovas
Narimantas E. Samalavičius
Published 2017-04-12
https://doi.org/10.15388/LietChirur.2017.10628
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Keywords

colonoscopy
colonic perforation
peritonitis
Iatrogenic injury

How to Cite

1.
Smolskas E, Dulskas A, Kildušienė I, Stratilatovas E, Samalavičius NE. Iatrogenic colonic perforation by colonoscopy: outcomes of surgery at a single center. LS [Internet]. 2017Apr.12 [cited 2022Aug.10];16(2):108-13. Available from: https://www.journals.vu.lt/lietuvos-chirurgija/article/view/10628

Abstract

Background
Although the incidence of iatrogenic colonoscopic perforation is low, it can result in severe complications and mortality. This study assessed the incidence and surgical management outcomes of iatrogenic colonic perforations.

Materials and Methods
We reviewed all the medical records of patients with colonic perforations during diagnostic or therapeutic colonoscopies from January 2007 to December 2016 at National Cancer Institute. We collected the patient’s demographic data, colono­scopic reports, and data regarding the location of perforations, their treatment and outcome.

Results
16 186 colonoscopies were performed at National Cancer Institute. The overall perforation rate was 0.14% (23 of 16 186). Of the total 23 colon perforations, 20 were managed operatively. The most common location was the sigmoid colon, in 12 cases. The most used surgical technique was simple suture (11 cases) followed by resection with anastomosis (6 cases). Three patients died (one because of multiple organ failure caused by acute bronchopneumonia and two patients with intra-abdominal sepsis died due cardiopulmonary insufficiency).

Conclusions: If surgery and its associated morbidity can be avoided in cases of colonic perforation the negative impact of a colonoscopy-associated complication can be minimized considerably. Patients need to be informed of the complications of colonoscopy, and clinicians must be cautioned about the potential problems for patients with a high anaesthetic risk when performing the procedure.

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