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Colonoscopic perforations: incidence, management, and outcomes.
Am Surg. 2004 Sep; 70(9):750-7; discussion 757-8.AS

Abstract

Fiberoptic colonoscopy provides superior diagnostic and therapeutic capabilities in the treatment of lower gastrointestinal disease processes. A well-recognized, but uncommon, complication during the procedure is perforation. The purpose of this study was to determine the incidence of colonoscopic perforation, define risk factors, assess the management of these complications, and evaluate outcomes. From January 1997 through December 2003, 43,609 colonoscopies were performed in our medical center. There were 14 (0.032%) perforations (1 in 3115 procedures); 7 from diagnostic and 7 from therapeutic procedures. General surgeons performed 1243 procedures (2.9%), and their rate of perforation was 0.080 per cent compared with 0.031 per cent for gastroenterologists during the same period. Half of the perforations occurred in the rectosigmoid, and the most common mechanism was mechanical (n = 6). Perforation was identified immediately during endoscopy in 50 per cent of the patients. Thirteen of 14 perforations were treated within 24 hours; 1 was delayed 48 hours. Initial surgical management was undertaken in 11/14 patients. Initial nonoperative treatment was attempted in three and was successful in only one patient. The mean length of stay following perforation was 11.2 days (range, 4-36 days). Three patients (21.4%) had 7 postoperative complications. Colonoscopic perforations are uncommon but can be recognized early and managed surgically with acceptable morbidity and postoperative length of stay.

Authors+Show Affiliations

Cobb WS
Carolinas Laparoscopic and Advanced Surgery Program, Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.
Heniford BT
No affiliation info available
Sigmon LB
No affiliation info available
Hasan R
No affiliation info available
Simms C
No affiliation info available
Kercher KW
No affiliation info available
Matthews BD
No affiliation info available

MeSH

AdultAgedAged, 80 and overColonic DiseasesColonoscopyDigestive System Surgical ProceduresFemaleHumansIncidenceIntestinal PerforationMaleMiddle AgedRisk FactorsTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15481289

Citation

Cobb, William S., et al. "Colonoscopic Perforations: Incidence, Management, and Outcomes." The American Surgeon, vol. 70, no. 9, 2004, pp. 750-7; discussion 757-8.
Cobb WS, Heniford BT, Sigmon LB, et al. Colonoscopic perforations: incidence, management, and outcomes. Am Surg. 2004;70(9):750-7; discussion 757-8.
Cobb, W. S., Heniford, B. T., Sigmon, L. B., Hasan, R., Simms, C., Kercher, K. W., & Matthews, B. D. (2004). Colonoscopic perforations: incidence, management, and outcomes. The American Surgeon, 70(9), 750-7; discussion 757-8.
Cobb WS, et al. Colonoscopic Perforations: Incidence, Management, and Outcomes. Am Surg. 2004;70(9):750-7; discussion 757-8. PubMed PMID: 15481289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colonoscopic perforations: incidence, management, and outcomes. AU - Cobb,William S, AU - Heniford,B Todd, AU - Sigmon,Lee B, AU - Hasan,Reem, AU - Simms,Connie, AU - Kercher,Kent W, AU - Matthews,Brent D, PY - 2004/10/16/pubmed PY - 2004/12/16/medline PY - 2004/10/16/entrez SP - 750-7; discussion 757-8 JF - The American surgeon JO - Am Surg VL - 70 IS - 9 N2 - Fiberoptic colonoscopy provides superior diagnostic and therapeutic capabilities in the treatment of lower gastrointestinal disease processes. A well-recognized, but uncommon, complication during the procedure is perforation. The purpose of this study was to determine the incidence of colonoscopic perforation, define risk factors, assess the management of these complications, and evaluate outcomes. From January 1997 through December 2003, 43,609 colonoscopies were performed in our medical center. There were 14 (0.032%) perforations (1 in 3115 procedures); 7 from diagnostic and 7 from therapeutic procedures. General surgeons performed 1243 procedures (2.9%), and their rate of perforation was 0.080 per cent compared with 0.031 per cent for gastroenterologists during the same period. Half of the perforations occurred in the rectosigmoid, and the most common mechanism was mechanical (n = 6). Perforation was identified immediately during endoscopy in 50 per cent of the patients. Thirteen of 14 perforations were treated within 24 hours; 1 was delayed 48 hours. Initial surgical management was undertaken in 11/14 patients. Initial nonoperative treatment was attempted in three and was successful in only one patient. The mean length of stay following perforation was 11.2 days (range, 4-36 days). Three patients (21.4%) had 7 postoperative complications. Colonoscopic perforations are uncommon but can be recognized early and managed surgically with acceptable morbidity and postoperative length of stay. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/15481289/Colonoscopic_perforations:_incidence_management_and_outcomes_ DB - PRIME DP - Unbound Medicine ER -