Tags

Type your tag names separated by a space and hit enter

Clinical presentation and management of iatrogenic colon perforations.
Am J Surg. 1996 Nov; 172(5):454-7; discussion 457-8.AJ

Abstract

BACKGROUND

Because iatrogenic colonic perforation is uncommon, surgical management of this complication has been based on the civilian trauma experience. In this study, we determine the incidence, clinical presentation, and management of colonic perforations resulting from colonoscopy or barium enema.

PATIENTS AND METHODS

The medical records of all patients with colorectal perforations due to barium enema or colonoscopy seen over a 5-year period were reviewed.

RESULTS

Twenty-one patients, 12 males and 9 females aged 66 +/- 16 years, undergoing evaluation for polyps and bleeding (11), diverticulosis (4), diarrhea (2), or miscellaneous indications (4) sustained colonic perforation from colonoscopy (18; 0.20%) or barium enema (3; 0.10%). Abdominal pain, 66% (13), and fever, 24% (5), were the most frequent symptoms encountered and extraluminal air, 67% (14), the most common radiologic finding. The site of perforation was the rectosigmoid in 62% (13) of patients. Eighteen patients underwent surgery; 11 within 24 hours (group I) and 7 patients within 6.0 +/- 4 days (group II). Fifty percent (9 of 18) had primary repair or resection with anastomosis without mortality. Of the 6 patients initially treated nonoperatively, 3 subsequently underwent surgery. Both deaths, one in group I and one in group II, occurred in patients who had colonic diversion for perforation following colonoscopy.

CONCLUSION

We conclude that in the absence of significant contamination either primary repair or resection and anastomosis can be performed with acceptable morbidity for iatrogenic perforations of the colon.

Links

Publisher Full Text

Authors+Show Affiliations

Gedebou TM
Department of General Surgery, University of Arizona Health Sciences Center, Tucson 85724, USA.
Wong RA
No affiliation info available
Rappaport WD
No affiliation info available
Jaffe P
No affiliation info available
Kahsai D
No affiliation info available
Hunter GC
No affiliation info available

MeSH

AdolescentAdultAgedAged, 80 and overBarium SulfateColonColonoscopyEnemaFemaleHumansIntestinal PerforationMaleMiddle AgedRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8942543

Citation

Gedebou, T M., et al. "Clinical Presentation and Management of Iatrogenic Colon Perforations." American Journal of Surgery, vol. 172, no. 5, 1996, pp. 454-7; discussion 457-8.
Gedebou TM, Wong RA, Rappaport WD, et al. Clinical presentation and management of iatrogenic colon perforations. Am J Surg. 1996;172(5):454-7; discussion 457-8.
Gedebou, T. M., Wong, R. A., Rappaport, W. D., Jaffe, P., Kahsai, D., & Hunter, G. C. (1996). Clinical presentation and management of iatrogenic colon perforations. American Journal of Surgery, 172(5), 454-7; discussion 457-8.
Gedebou TM, et al. Clinical Presentation and Management of Iatrogenic Colon Perforations. Am J Surg. 1996;172(5):454-7; discussion 457-8. PubMed PMID: 8942543.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical presentation and management of iatrogenic colon perforations. AU - Gedebou,T M, AU - Wong,R A, AU - Rappaport,W D, AU - Jaffe,P, AU - Kahsai,D, AU - Hunter,G C, PY - 1996/11/1/pubmed PY - 1996/11/1/medline PY - 1996/11/1/entrez SP - 454-7; discussion 457-8 JF - American journal of surgery JO - Am J Surg VL - 172 IS - 5 N2 - BACKGROUND: Because iatrogenic colonic perforation is uncommon, surgical management of this complication has been based on the civilian trauma experience. In this study, we determine the incidence, clinical presentation, and management of colonic perforations resulting from colonoscopy or barium enema. PATIENTS AND METHODS: The medical records of all patients with colorectal perforations due to barium enema or colonoscopy seen over a 5-year period were reviewed. RESULTS: Twenty-one patients, 12 males and 9 females aged 66 +/- 16 years, undergoing evaluation for polyps and bleeding (11), diverticulosis (4), diarrhea (2), or miscellaneous indications (4) sustained colonic perforation from colonoscopy (18; 0.20%) or barium enema (3; 0.10%). Abdominal pain, 66% (13), and fever, 24% (5), were the most frequent symptoms encountered and extraluminal air, 67% (14), the most common radiologic finding. The site of perforation was the rectosigmoid in 62% (13) of patients. Eighteen patients underwent surgery; 11 within 24 hours (group I) and 7 patients within 6.0 +/- 4 days (group II). Fifty percent (9 of 18) had primary repair or resection with anastomosis without mortality. Of the 6 patients initially treated nonoperatively, 3 subsequently underwent surgery. Both deaths, one in group I and one in group II, occurred in patients who had colonic diversion for perforation following colonoscopy. CONCLUSION: We conclude that in the absence of significant contamination either primary repair or resection and anastomosis can be performed with acceptable morbidity for iatrogenic perforations of the colon. SN - 0002-9610 UR - https://www.unboundmedicine.com/medline/citation/8942543/Clinical_presentation_and_management_of_iatrogenic_colon_perforations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(96)00236-X DB - PRIME DP - Unbound Medicine ER -