Perforations are known to occur after colonoscopy. In a consecutive study the localization of the perforation was determined, and the etiology of the perforation was classified as: therapeutic, barotraumatic or mechanical. A colonic perforation occurred in 26 of 19 135 patients (0.14 %). In 13 cases (50.0 %) the cause of perforation was mechanical, in nine (34.6 %) the cause was a barotrauma (cecal blow-out), and in three cases (11.5 %) it was due to a therapeutic procedure (coagulation or polypectomy). In one case (3.8 %) data were not available. Cecal blow-out occurred significantly more often as a result of barotrauma, whereas perforation of the sigmoid occurred more often as a result of direct mechanical trauma. The risk of perforation after colonoscopy is rather low. Barotrauma due to insufflated air occurs more often than therapeutic perforation due to polypectomy or coagulation. Patients with a higher risk of perforation are those with diverticula in the sigmoid.
References
-
1
Lohsiriwat V, Sujariktanakarn S, Akaraviputch T et al.
What are the risk factors of colonoscopic perforation?.
BMC Gastroenterol.
2009;
9
71
-
2
Lüning T H, Keemers-Gels M E, Barendregt W B et al.
Colonoscopic perforations: a review of 30,366 patients.
Surg Endosc.
2007;
21
994-997
-
3
Iqbal C W, Chun Y S, Farley D R.
Colonoscopic perforations: a retrospective review.
J Gastrointest Surg.
2005;
9
1229-12 235
-
4
Rotholz N A, Laporte M, Lencinas S et al.
Laparoscopic approach to colonic perforation due to colonoscopy.
World J Surg.
2010;
34
1949-1953
-
5
Panteris V, Haringsma J, Kuipers E J.
Colonoscopy perforation rate, mechanisms and outcome: from diagnostic to therapeutic colonoscopy.
Endoscopy.
2009;
41
941-951
-
6
Kang H Y, Kang H W, Kim S G et al.
Incidence and management of colonoscopic perforations in Korea.
Digestion.
2008;
78
218-223
-
7
Taku K, Sano Y, Fu K I et al.
Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan.
J Gastroenterol Hepatol.
2007;
22
1409-1414
-
8
Iqbal C W, Chun Y S, Farley D R.
Colonoscopic perforations: a retrospective review.
J Gastrointest Surg.
2005;
9
1229-1235
-
9
Lohsiriwat V.
Colonoscopic perforation: incidence, risk factors, management and outcome.
World J Gastroenterol.
2010;
16
425-430
-
10
Woltjen J A.
A retrospective analysis of cecal barotrauma caused by colonoscope aire flow and pressure.
Gastrointest Endosc.
2005;
61
37-45
-
11
Hough D M, Kuntz M A, Fidler J L et al.
Detection of occult colonic perforation before CT colonography after incomplete colonoscopy: perforation rate and use of a low-dose diagnostic scan before CO2 insufflation.
AJR.
2008;
191
1077-1081
R. J. L. F. LoffeldMD, PhD
Department of Internal Medicine
Zaans Medisch Centrum
PO BOX 210 1500 EE Zaandam
The Netherlands
Fax: +31-75-6502379
Email: loffeld.r@zaansmc.nl
