Treatment and Outcomes of Iatrogenic Colon Perforations at a Community Teaching Hospital

Matharoo, Gurdeep S.; Goldfarb, Michael A.

doi:10.1177/000313481207800938

Cited by 7 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If colon perforation develops, panperitonitis, acute abdominal compartment syndrome, ostomy creation, or death may develop [ 4 ]. The most common site of colon perforation is the sigmoid colon [ 5 ]. In the present study, we also found that 70.4% of the colon perforations developed at the sigmoid colon.…”

Section: Discussionmentioning

confidence: 99%

Prompt Management Is Most Important for Colonic Perforation After Colonoscopy

et al. 2014

View full text Add to dashboard Cite

PurposeThe incidence of complications after colonoscopy is very low. The complications after colonoscopy that are of clinical concern are bleeding and perforation. The present study was conducted to determine the clinical outcomes and the risk factors of a colostomy or a colectomy after colonoscopic colon perforation.MethodsFrom March 2009 to December 2012, the records of all patients who were treated for colorectal perforation after colonoscopy were reviewed retrospectively. The following parameters were evaluated: age, sex, purpose of colonoscopy, management of the colonic perforation, and interval from colonoscopy to the diagnosis of a colonic perforation. A retrospective analysis was performed to determine the risk factors associated with major surgery for the treatment of a colon perforation after colonoscopy.ResultsA total 27 patients were included in the present study. The mean age was 62 years, and 16 were males. The purpose of colonoscopy was diagnostic in 18 patients. The most common perforation site was the sigmoid colon. Colonic perforation was diagnosed during colonoscopy in 14 patients, just after colonoscopy in 5 patients, and 24 hours or more after colonoscopy in 8 patients. For the treatment of colonic perforation, endoscopic clipping was performed in 3 patients, primary closure in 15 patients, colon resection in 2 patients, Hartmann's procedures in 4 patients, and diverting colostomy in 3 patients. If the diagnosis of perforation after colonoscopy was delayed for more than 24 hours, the need for major treatment was increased significantly.ConclusionAlthough a colonic perforation after colonoscopy is rare, if the morbidity and the mortality associated with the colonic perforation are to be reduced, prompt diagnosis and management are very important.

show abstract

Section: Discussionmentioning

confidence: 99%

Prompt Management Is Most Important for Colonic Perforation After Colonoscopy

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Published series reported high mortality among patients with colonoscopic perforation [ 3 - 6 ]. Early exploratory laparotomy with primary closure or bowel resection has been the standard treatment of colonoscopic perforation; however, relatively high morbidity and mortality rates were reported [ 7 - 10 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal Methods for the Management of Iatrogenic Colonoscopic Perforation

Shin

Park

et al. 2016

Clin Endosc

View full text Add to dashboard Cite

Background/Aims:Colonoscopic perforations have been managed with exploratory laparotomy, and have resulted in some morbidity and mortality. Recently, laparoscopic surgery is commonly performed for this purpose. The aim of this study was to compare the outcomes of several management strategies for iatrogenic colonoscopic perforations.Methods:We retrospectively reviewed the medical records of patients who had been treated for colonoscopic perforation between January 2004 and April 2013 at CHA Bundang Medical Center in Korea.Results:A total of 41 patients with colonoscopic perforation were enrolled. Twenty patients underwent conservative management with a success rate of 90%. Surgical management was performed in 23 patients including two patients who were converted to surgical management after the failure of the initial conservative management. Among 14 patients who underwent surgery at 8 hours after the perforation, there was no considerable difference in adverse outcomes between the laparotomy group and the laparoscopic surgery group. The medical costs and claim rate were 1.45 and 1.87 times greater in the exploratory laparotomy group, respectively.Conclusions:Conservative management of colonoscopic perforation could be an option for patients without overt symptoms of peritonitis or with a small defect size. If surgical management is required, laparoscopic surgery may be considered as the initial procedure even with a delayed diagnosis.

show abstract