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Colon perforation during colonoscopy: surgical versus conservative management.

Authors
  • Hall, C
  • Dorricott, N J
  • Donovan, I A
  • Neoptolemos, J P
Type
Published Article
Journal
The British journal of surgery
Publication Date
May 01, 1991
Volume
78
Issue
5
Pages
542–544
Identifiers
PMID: 2059801
Source
Medline
License
Unknown

Abstract

A survey of endoscopy units in the West Midlands, UK, was undertaken to ascertain the management of colonic perforation during colonoscopy. Fifteen perforations were reported from a total of 17,500 colonoscopies performed in 14 units (a rate of 0.09 per cent). In seven patients the diagnosis was suspected or diagnosed immediately and in the remaining eight 2-72 h later. Four patients with associated pathology (carcinoma, Crohn's disease, ulcerative colitis and a polyp) had resection and primary anastomosis. Seven patients had a simple oversew, four of these having had a delayed diagnosis. In four cases the site of perforation was not identified, but only one patient had conservative treatment. Three patients had drainage and a defunctioning colostomy. There was no significant morbidity following treatment. It is recommended that patients who have had a good bowel preparation should be treated conservatively unless there is a large perforation or an underlying carcinoma.

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