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World J Gastroenterol. Jul 14, 2006; 12(26): 4211-4213
Published online Jul 14, 2006. doi: 10.3748/wjg.v12.i26.4211
Incidence and management of colonoscopic perforations: 8 years’ experience
Hagit Tulchinsky, Osnat Madhala-Givon, Nir Wasserberg, Shlomo Lelcuk, Yaron Niv
Hagit Tulchinsky, Osnat Madhala-Givon, Nir Wasserberg, Shlomo Lelcuk, Department of Surgery B, Rabin Medical Center, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Yaron Niv, Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Author contributions: All authors contributed equally to the work.
Correspondence to: Hagit Tulchinsky, MD, Department of Surgery B, Sourasky Medical Center, 6 Veizman St., Tel Aviv 64239, Israel. hagitt@tasmc.health.gov.il
Telephone: +972-3-6973209 Fax: +972-3-6974635
Received: June 25, 2005
Revised: July 10, 2005
Accepted: July 15, 2005
Published online: July 14, 2006
Abstract

AIM: To review the experience of a major medical teaching center with diagnostic and therapeutic colonoscopies and to assess the incidence and management of related colonic perforations.

METHODS: All colonoscopies performed between January 1994 and December 2001 were studied. Data on patients, colonoscopic reports and procedure-related complications were collected from the departmental computerized database. The medical records of the patients with post procedural colonic perforation were reviewed.

RESULTS: A total of 12 067 colonoscopies were performed during the 8 years of the study. Seven colonoscopic perforations (4 females, 3 males) were diagnosed (0.058%). Five occurred during diagnostic and two during therapeutic colonoscopy. Six were suspected during or immediately after colonoscopy. All except one had signs of diffuse tenderness and underwent immediate operation with primary repair done in 4 patients. No deaths were reported.

CONCLUSION: Perforation rate during colonoscopy is low. Nevertheless, it is a serious complication and its early recognition and treatment are essential to optimize outcome. In patients with diffuse peritonitis early operative intervention makes primary repair a safe option.

Keywords: Colonoscopy; Complications; Perforation; Polypectomy; Management