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World J Gastrointest Endosc. Jul 10, 2015; 7(8): 819-823
Published online Jul 10, 2015. doi: 10.4253/wjge.v7.i8.819
Management of iatrogenic colorectal perforation: From surgery to endoscopy
Shi-Lun Cai, Tao Chen, Li-Qing Yao, Yun-Shi Zhong
Shi-Lun Cai, Tao Chen, Li-Qing Yao, Yun-Shi Zhong, Endoscopic Center, Zhongshan Hospital of Fudan University, Shanghai 200032, China
Author contributions: Cai SL and Chen T wrote the article; Cai SL and Yao LQ revised and polished the article; Chen T and Zhong YS designed the study.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yun-Shi Zhong, Professor, Endoscopic Center, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai 200032, China. zhongamy2002@126.com
Telephone: +86-21-64041990 Fax: +86-21-64041990
Received: August 31, 2014
Peer-review started: September 3, 2014
First decision: December 17, 2014
Revised: April 10, 2015
Accepted: April 27, 2015
Article in press: April 29, 2015
Published online: July 10, 2015
Processing time: 317 Days and 7.6 Hours
Abstract

Iatrogenic colon perforation is one the most pernicious complications for patients undergoing endoscopic screening or therapy. It is a serious but rare complication of colonoscopy. However, with the expansion of the indications for endoscopic therapies for gastrointestinal diseases, the frequency of colorectal perforation has increased. The management of iatrogenic colorectal perforation is still a challenge for many endoscopists. The methods for treating this complication vary, including conservative treatment, surgical treatment, laparoscopy and endoscopy. In this review, we highlight the etiology, recognition and treatment of colorectal iatrogenic perforation. Specifically, we shed light on the endoscopic management of this rare complication.

Keywords: Iatrogenic perforation; Colorectum; Surgery; Laparoscopy; Endoscopy

Core tip: Iatrogenic colorectal perforation is one of the most pernicious complications for patients who undergo endoscopic screening or therapy. In this review, we highlight the etiology, recognition and treatment of colorectal iatrogenic perforation, including conservative treatment, surgical treatment and laparoscopy. The flying development of the endoscope and its surgical assistant accessories have improved the endoscopic clip closure procedure. It can remarkably decrease the rate of surgical reparation following iatrogenic perforation of the colon.