Review
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 28, 2010; 16(4): 425-430
Published online Jan 28, 2010. doi: 10.3748/wjg.v16.i4.425
Colonoscopic perforation: Incidence, risk factors, management and outcome
Varut Lohsiriwat
Varut Lohsiriwat, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Author contributions: Lohsiriwat V performed the literature review, acquisition and analysis of data, and manuscript preparation.
Supported by Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Correspondence to: Varut Lohsiriwat, MD, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Prannok Road, Bangkok 10700, Thailand. bolloon@hotmail.com
Telephone: +66-2419-8077  Fax: +66-2411-5009
Received: October 11, 2009
Revised: November 9, 2009
Accepted: November 16, 2009
Published online: January 28, 2010
Abstract

This review discusses the incidence, risk factors, management and outcome of colonoscopic perforation (CP). The incidence of CP ranges from 0.016% to 0.2% following diagnostic colonoscopies and could be up to 5% following some colonoscopic interventions. The perforations are frequently related to therapeutic colonoscopies and are associated with patients of advanced age or with multiple comorbidities. Management of CP is mainly based on patients’ clinical grounds and their underlying colorectal diseases. Current therapeutic approaches include conservative management (bowel rest plus the administration of broad-spectrum antibiotics), endoscopic management, and operative management (open or laparoscopic approach). The applications of each treatment are discussed. Overall outcomes of patients with CP are also addressed.

Keywords: Colonoscopic perforation; Colonoscopy; Sigmoidoscopy; Complication; Postpolypectomy syndrome; Incidence; Risk factors; Treatment; Management; Outcome