![]() ![]() Fujinon series colonoscopes (EC-250 WL5, 530, 600 EC, 600 WL, 700 series) were used. Pre-anesthetic examinations were performed before the procedure. Each endoscopist applied his own protocol for colon cleansing of the patients. The endoscopy experience of the specialists ranged from 2 to 25 years. The procedures were performed by ten general surgeons and five gastroenterologists. The colonoscopy technique followed by the endoscopists, adequacy of colon cleansing procedure, and how the perforation was detected were recorded.Īll procedures were performed with sedoanalgesia (midazolam, propofol -/+ pethidine) under the supervision of an anesthesiologist. Demographic characteristics of the patients, features of the colonoscopy procedure (diagnostic or therapeutic), diagnosis of perforation and characteristics of perforation, treatment modalities, and results were assessed. Material and MethodsĬases of ICP in patients who had undergone lower gastrointestinal system endoscopy (rectosigmoidoscopy and colonoscopy) in the endoscopy unit of our hospital between January 2002 and December 2020 were evaluated retrospectively. In this study, we aimed to discuss the characteristics of the cases of ICP, the underlying reasons for its occurrence, our treatment approaches, and results in the light of the current literature. According to the characteristics of the perforation, endoscopic or surgical therapy must be chosen ( 10- 12). The experience of and attention given to such complications by the endoscopist are crucial. ![]() ![]() Formation of iatrogenic colon perforation (ICP) is reported to be related with the age of the patient, insufficient bowel cleansing, presence of dolichocolon, previous abdominal surgeries, procedure type, use of analgesics during the procedure, procedure speed and insufficiency of the time allocated, experience of the endoscopist performing the procedure, and quality of the endoscopy system ( 6- 8).ĭetection and treatment of colon perforation during the procedure is critical in preventing mortality and morbidity ( 9). Major cause of mortality is generalized peritonitis and sepsis as a consequence of late detection of perforation and delayed treatment ( 4, 5). Mortality due to colon perforation has been reported in the range of 0%-0.05% ( 3). Perforation frequency is reported to range from 0.03% to 0.8% in diagnostic colonoscopy ( 2). During this procedure, bleeding and perforation that occur independently or iatrogenic are the most feared and common complications ( 1). Keywords: Colon perforation, colonoscopy, complication IntroductionĬolonoscopy is the most effective diagnostic/treatment method in the detection and treatment of colon and distal ileum pathologies. The patients who did not develop complications in the postoperative follow-up were discharged with full recovery.Ĭonclusion: Prompt diagnosis and appropriate treatment of ICP is crucial to prevent morbidity and mortality. The patients were hospitalized for an average of 7.14 days. In the patients who underwent laparotomy, primary repair was performed in three patients, partial colon resection and end-to-end anastomosis in one patient, and loop colostomy in one patient. Whereas surgical procedures were performed in all patients, the type of the procedure varied laparoscopic primary repair was performed in two patients and laparotomy in five patients. The diagnosis was made during the procedure in six patients and after eight hours in one patient, and their treatment was performed urgently. ![]() Results: A total of seven cases of ICP were detected. Material and Methods: We retrospectively evaluated the cases of ICP among 9.709 lower gastrointestinal system endoscopy procedures (colonoscopy + rectosigmoidoscopy) performed for diagnostic purposes in our endoscopy clinic during 2002-2020. In this study, we aimed to discuss the characteristics of the cases of ICP we encountered in our endoscopy clinic, its etiology, our treatment approaches, and results in the light of the current literature. Objective: latrogenic colon perforation (ICP) is one of the most feared complications of colonoscopy and causes unwanted morbidity and mortality. Nihat Gülaydın 1, Raim İliaz 2, Atakan Özkan 1, A Hande Gökçe 1, Hanifi Önalan 1, Berrin Önalan 3, Aziz Arı 4ġDepartment of General Surgery, Atlas University Faculty of Medicine, İstanbul, TürkiyeĢDepartment of Gastroenterology, Atlas University Faculty of Medicine, İstanbul, TürkiyeģClinic of General Surgery, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, TürkiyeĤClinic of General Surgery, İstanbul Training and Research Hospital, İstanbul, Türkiye Abstract Iatrogenic colon perforation during colonoscopy, diagnosis/treatment, and follow-up processes: A single-center experience ![]()
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