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Prompt Management Is Most Important for Colonic Perforation After Colonoscopy

PURPOSE: The 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 colonoscop...

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Autores principales: Kim, Hyun-Ho, Kye, Bong-Hyeon, Kim, Hyung-Jin, Cho, Hyeon-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Coloproctology 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213939/
https://www.ncbi.nlm.nih.gov/pubmed/25360430
http://dx.doi.org/10.3393/ac.2014.30.5.228
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author Kim, Hyun-Ho
Kye, Bong-Hyeon
Kim, Hyung-Jin
Cho, Hyeon-Min
author_facet Kim, Hyun-Ho
Kye, Bong-Hyeon
Kim, Hyung-Jin
Cho, Hyeon-Min
author_sort Kim, Hyun-Ho
collection PubMed
description PURPOSE: The 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. METHODS: From 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. RESULTS: A 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. CONCLUSION: Although 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.
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spelling pubmed-42139392014-10-30 Prompt Management Is Most Important for Colonic Perforation After Colonoscopy Kim, Hyun-Ho Kye, Bong-Hyeon Kim, Hyung-Jin Cho, Hyeon-Min Ann Coloproctol Original Article PURPOSE: The 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. METHODS: From 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. RESULTS: A 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. CONCLUSION: Although 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. The Korean Society of Coloproctology 2014-10 2014-10-28 /pmc/articles/PMC4213939/ /pubmed/25360430 http://dx.doi.org/10.3393/ac.2014.30.5.228 Text en © 2014 The Korean Society of Coloproctology http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Hyun-Ho
Kye, Bong-Hyeon
Kim, Hyung-Jin
Cho, Hyeon-Min
Prompt Management Is Most Important for Colonic Perforation After Colonoscopy
title Prompt Management Is Most Important for Colonic Perforation After Colonoscopy
title_full Prompt Management Is Most Important for Colonic Perforation After Colonoscopy
title_fullStr Prompt Management Is Most Important for Colonic Perforation After Colonoscopy
title_full_unstemmed Prompt Management Is Most Important for Colonic Perforation After Colonoscopy
title_short Prompt Management Is Most Important for Colonic Perforation After Colonoscopy
title_sort prompt management is most important for colonic perforation after colonoscopy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213939/
https://www.ncbi.nlm.nih.gov/pubmed/25360430
http://dx.doi.org/10.3393/ac.2014.30.5.228
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