Emergency cases following elective colonoscopy: Iatrogenic colonic perforation

Abstract

Objective: Our aim in this study was to present the cases of our patients who contracted colonic perforation during elective colonoscopy and became emergency cases; we also discuss treatment modalities along with literature reports on the subject.
Material and Methods: Cases of patients who contracted iatrogenic colonic perforation following endoscopy of the colorectal system between January 2009 and December 2015 at Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital’s Endoscopy Unit were reviewed retrospectively.
Results: Within the duration of the study, 5.586 patients underwent colonoscopies at our hospital; 7 (0.12%) of these patients contracted iatrogenic colonic perforation. Three (42.8%) of these patients were male, four (57.2%) were female, and their mean age was 69 years (46 to 84). Six (85.7%) patients were diagnosed intraoperationally, while one (14.3%) patient was diagnosed 12 hours after the procedure. The perforation area was the sigmoid colon in six patients and the ascending colon in one patient; all patients underwent surgery. Four patients were discharged with no complications. One of the remaining three patients had enterocutaneous fistula, one had acute renal failure, and one died of sepsis.
Conclusion: The progress of perforation due to colonoscopy varies according to the underlying diseases, the mechanism of perforation formation, the treatment modality used, and the experience of the physicians treating the patient. Special attention should be paid to senior and comorbid patients receiving therapeutic procedures during colonoscopy.

Cite this paper as: Gündeş E, Çiyiltepe H, Aday U, Çetin DA, Senger AS, Uzun O, et al. Emergency cases following elective colonoscopy: Iatrogenic colonic perforation. Turk J Surg 2017; 33: 248-252.
This study was presented at the IV. National Gastroenterology Surgery Congress, 27 April-1 May, 2016, Antalya, Turkey.

Authors declared that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects” (amended in October 2013).

Informed consent was not received due to the retrospective nature of the study.

Externally peer-reviewed.

Concept - E.G., H.Ç.; Design - E.G., U.A.; Supervision - D.A.Ç., A.S.S.; Resource - O.U.; Materials - E.G., K.C.D.; Data Collection and/or Processing - E.G.; Analysis and/or Interpretation - E.G., K.C.D.; Literature Search - K.C.D., U.A.; Writing Manuscript - E.G., U.A., D.A.Ç.; Critical Reviews - E.P., M.D.

No conflict of interest was declared by the authors.

The authors declared that this study has received no financial support.