OBJECTIVE: the aim of this retrospective study was to evaluate the incidence of colon perforations from diagnostic and therapeutic colonoscopies, and to assess their management in our hospital. PATIENTS AND METHOD: perforations resulting from colonoscopy in our hospital were reviewed for the period January, 1991 to December, 2006. The study analyzed: purpose of procedure, lesion mechanisms, clinical and radiological presentations, delays in diagnosis, patient status, therapeutic handling, and outcome. RESULT: fifteen perforations (0.09%) (9 males and 6 females) out of a total of 16,285 colonoscopies carried out were seen to have taken place during the study period. Nine of these occurred after diagnostic colonoscopies, and 6 occurred after therapeutic endoscopies. Around 60% of perforations were detected by the endoscopist while carrying out the procedure (88.6% during diagnostic endoscopy, and 16.6% during therapeutic endoscopy). In 73.7% of cases abdominal pain and distension were the most frequent symptoms; extraluminal gas was seen in 100% of cases with imaging techniques. Delayed diagnosis (> 24 hours) occurred in 40% of patients (range: 1-6 days). Twelve patients were operated upon (80%), of whom 4 were ASA II and 8 were ASA III/IV. Postoperative morbidity was 44.44%, and mortality was 25%. The outcome of patients receiving conservative treatment was found to be satisfactory. CONCLUSION: perforation of the colon during colonoscopy is a rare complication with serious -even lethal- consequences. Conservative treatment can be provided for selected cases under strict clinical control. Type of surgery will depend on the lesion location and size, concomitant colon pathology, and degree of fecal contamination. Mortality seems to be related to general status rather than the surgical technique used.
OBJECTIVE: the aim of this retrospective study was to evaluate the incidence of colon perforations from diagnostic and therapeutic colonoscopies, and to assess their management in our hospital. PATIENTS AND METHOD: perforations resulting from colonoscopy in our hospital were reviewed for the period January, 1991 to December, 2006. The study analyzed: purpose of procedure, lesion mechanisms, clinical and radiological presentations, delays in diagnosis, patient status, therapeutic handling, and outcome. RESULT: fifteen perforations (0.09%) (9 males and 6 females) out of a total of 16,285 colonoscopies carried out were seen to have taken place during the study period. Nine of these occurred after diagnostic colonoscopies, and 6 occurred after therapeutic endoscopies. Around 60% of perforations were detected by the endoscopist while carrying out the procedure (88.6% during diagnostic endoscopy, and 16.6% during therapeutic endoscopy). In 73.7% of cases abdominal pain and distension were the most frequent symptoms; extraluminal gas was seen in 100% of cases with imaging techniques. Delayed diagnosis (> 24 hours) occurred in 40% of patients (range: 1-6 days). Twelve patients were operated upon (80%), of whom 4 were ASA II and 8 were ASA III/IV. Postoperative morbidity was 44.44%, and mortality was 25%. The outcome of patients receiving conservative treatment was found to be satisfactory. CONCLUSION: perforation of the colon during colonoscopy is a rare complication with serious -even lethal- consequences. Conservative treatment can be provided for selected cases under strict clinical control. Type of surgery will depend on the lesion location and size, concomitant colon pathology, and degree of fecal contamination. Mortality seems to be related to general status rather than the surgical technique used.
Authors: Khalid N Alsowaina; Mooyad A Ahmed; Nawar A Alkhamesi; Ahmad I Elnahas; Jeffrey D Hawel; Nitin V Khanna; Christopher M Schlachta Journal: Surg Endosc Date: 2019-08-26 Impact factor: 4.584
Authors: Nicola de'Angelis; Salomone Di Saverio; Osvaldo Chiara; Massimo Sartelli; Aleix Martínez-Pérez; Franca Patrizi; Dieter G Weber; Luca Ansaloni; Walter Biffl; Offir Ben-Ishay; Miklosh Bala; Francesco Brunetti; Federica Gaiani; Solafah Abdalla; Aurelien Amiot; Hany Bahouth; Giorgio Bianchi; Daniel Casanova; Federico Coccolini; Raul Coimbra; Gian Luigi de'Angelis; Belinda De Simone; Gustavo P Fraga; Pietro Genova; Rao Ivatury; Jeffry L Kashuk; Andrew W Kirkpatrick; Yann Le Baleur; Fernando Machado; Gustavo M Machain; Ronald V Maier; Alain Chichom-Mefire; Riccardo Memeo; Carlos Mesquita; Juan Carlos Salamea Molina; Massimiliano Mutignani; Ramiro Manzano-Núñez; Carlos Ordoñez; Andrew B Peitzman; Bruno M Pereira; Edoardo Picetti; Michele Pisano; Juan Carlos Puyana; Sandro Rizoli; Mohammed Siddiqui; Iradj Sobhani; Richard P Ten Broek; Luigi Zorcolo; Maria Clotilde Carra; Yoram Kluger; Fausto Catena Journal: World J Emerg Surg Date: 2018-01-24 Impact factor: 5.469