Risk of perforation from a colonoscopy in adults: a large population-based study

Arora, Gaurav; Mannalithara, Ajitha; Singh, Gurkirpal; Gerson, Lauren B.; Triadafilopoulos, George

doi:10.1016/j.gie.2008.09.008

Cited by 233 publications

(172 citation statements)

References 44 publications

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“…No deaths were recorded in our series. Mortality from colonoscopy has been reported to be as high as 0.07% (1 death every 1500 colonoscopies) [41] though the rate is much lower when colonoscopy is used for screening purposes [42]. Our data on perforations is similar to that reported by the American survey [20,21] and favorably compares with the data from the survey performed in UK and Israel [18,19].…”

Section: Discussionsupporting

confidence: 83%

“…When comparing our data with the endoscopic series, the perforation rate at colonoscopy, whether diagnostic or therapeutic, would appear to be higher than that of CTC. The reported perforation rates for colonoscopy range from one case in 3115 procedures (0.032%) to one case in 510 procedures (0.196%) [17,[39][40][41][42][43][44]. Thus, our 0.02% estimate of post-CT colonography perforations imparts a significantly more favorable profile for CTC compared to colonoscopy.…”

Section: Discussionmentioning

confidence: 98%

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Adverse events of computed tomography colonography: An Italian National Survey

Iafrate¹,

Iussich²,

Correale³

et al. 2013

Digestive and Liver Disease

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a b s t r a c tAim: To retrospectively study the frequency and magnitude of complications associated with computed tomography (CT) colonography in clinical practice. Methods: A questionnaire on complications of CT colonography was sent to Italian public radiology departments identified as practicing CT colonography with a reasonable level of training. The frequency of complications and possible risk factors were retrospectively determined. Responses were collated and row frequencies determined. A multivariate analysis of the factors causing adverse events was also performed. Results: 40,121 examinations were performed in13 centers during the study period. No deaths were reported. Bowel perforations occurred in 0.02% (7 exams). All perforations were asymptomatic and occurred in patients undergoing manual insufflation. Five perforations (71%) occurred in procedures performed following a recent colonoscopy. There was no significant difference between perforations associated with rectal balloon (0.017%) and those that were not (0.02%). Complications related to vasovagal reaction (either with or without spasmolytic) occurred in 0.16% (63 exams). All vasovagal reactions resolved in less than 3 h, without any sequelae. Conclusions: Perforation rate at CT colonography in Italy is comparable with elsewhere in the world, occurring regardless of the experience of radiology centers. Although the risk is very small, it may not be negligible when compared with the risk of diagnostic colonoscopy.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 98%

Adverse events of computed tomography colonography: An Italian National Survey

Iafrate¹,

Iussich²,

Correale³

et al. 2013

Digestive and Liver Disease

View full text Add to dashboard Cite

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“…Also, there was a high rate of more than 72-hour delay in the presentation of the referred cases with bleeding per rectum which may lower the diagnostic yield in these delayed cases. Although, colonoscopy is generally safe, it is an invasive procedure that can rarely be complicated by perforation, hemorrhage and infection [21,22]. None of these complications was recorded in this study.…”

Section: Discussionmentioning

confidence: 70%

Diagnostic Yield of Colonoscopy

Ray-Offor¹,

Ibeanusi²

2018

J Clin Gastroenterol Hepatol

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“…Previous studies have shown that patients over 65 years of age present significant risks for perforation (1,(21)(22)(23). In some studies, it has been reported that the perforation rate in patients over 75 years of age can increase by four to six times compared to that in young patients (24,25 (24) observed that the perforation rate is higher in patients with two or more comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Colonoscopic perforations: Single center experience and review of the literature

Çolak¹,

Gürbulak²,

Bektaş³

et al. 2017

Turk J Surg

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Colonoscopic perforations: Single center experience and review of the literature INTRODUCTION Colonoscopy is accepted as the gold standard imaging modality for the diagnosis of colon and distal ileum diseases. It aids the detection of smaller lesions and tissue sampling and also functions as a therapeutic procedure for intestinal diseases. Similar to other invasive procedures, colonoscopy has been associated with various complications; among these, perforation is the most important. Iatrogenic colonic perforation has high rates of mortality and morbidity. It is mainly divided into two categories: diagnostic and therapeutic (1, 2). Management includes both medical and surgical approaches. However, the best approach for treatment depends on various factors, such as the patient's general condition, age, comorbidities, and, most importantly, the time between the onset and diagnosis of perforation. In this study, we aimed to evaluate the incidence of perforation in a large colonoscopy series, discuss patient management strategies, and analyze the clinical consequences of iatrogenic colonic perforation. MATERIAL AND METHODSBetween January 2005 and May 2015, a total of 31,655 lower GIS endoscopies were performed at our center. Patients with iatrogenic colonic perforations were investigated retrospectively. All procedures were conducted under sedoanalgesia. The procedures were performed by 27 endoscopists, including 24 general surgeons and 3 gastroenterology specialists. The experience of the endoscopists varied between 2 and 15 years.We analyzed the demographic characteristics of the patients, the type of procedure (therapeutic or diagnostic), indications for colonoscopy and associated colonic disease, location and detection time of perforation, management strategy (operative or nonoperative), and complications.The perforations were detected either during colonoscopy by observing a visible defect in the colonic wall (mesenteric or antimesenteric side) or after the procedure by detecting free intra-abdominal air upon radiological examination. Patients who complained of abdominal pain or distention following 195Objective: Iatrogenic colonic perforation is a well-known complication that can increase mortality and morbidity in patients undergoing colonoscopy. Closer follow-up and a well-planned treatment strategy are required when perforation arises as a complication. The aims of this study are to (1) report our experience with a large colonoscopy series; (2) evaluate the underlying mechanisms of iatrogenic colonic perforation; (3) discuss the ideal period between onset and treatment; and (4) review the current literature regarding the management of iatrogenic colonic perforations. Material and Methods:Patients who underwent colonoscopy between January 2005 and May 2015 at a single center were reviewed retrospectively. Procedures during which colonic perforations occurred were documented and analyzed.Results: Between January 2005 and May 2015, 31,655 patients underwent colonoscopy and 5,214 patients underwent recto-sigmoi...

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Risk of perforation from a colonoscopy in adults: a large population-based study

Cited by 233 publications

References 44 publications

Adverse events of computed tomography colonography: An Italian National Survey

Adverse events of computed tomography colonography: An Italian National Survey

Diagnostic Yield of Colonoscopy

Colonoscopic perforations: Single center experience and review of the literature

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