Gastrointest Interv.  2018 Jul;7(2):94-97. 10.18528/gii180023.

Large-sized iatrogenic colonic perforation during diagnostic colonoscopy

Affiliations
  • 1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. jaejpark@yuhs.ac
  • 2Division of Colon and Rectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract

SUMMARY OF EVENT: A 2 cm-sized colonic perforation occurred during diagnostic colonoscopy. Endoscopic closure was performed immediately using detachable snare and conservative management with intravenous antibiotics was followed for several days. However, abdominal computed tomography showed huge abscess and its connection to the sigmoid colon. The patient underwent segmental colectomy, which revealed the incomplete closure of perforated lesion with severe serosal fibrotic change. TEACHING POINT: Endoscopic treatment of large-sized colonic perforations should be undertaken with caution since the possibility of incomplete closure is high. For large-sized colonic perforations, early surgical treatment should be preferentially considered over endoscopic treatment.

Keyword

Colon; Endoscopic closure; Iatrogenic perforation; Surgical treatment

MeSH Terms

Abscess
Anti-Bacterial Agents
Colectomy
Colon*
Colon, Sigmoid
Colonoscopy*
Humans
SNARE Proteins
Anti-Bacterial Agents
SNARE Proteins
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