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Evaluation of patients with Iatrogenic colon perforation caused during colonoscopy

Year 2018, Volume: 26 Issue: 1, 27 - 29, 26.04.2018
https://doi.org/10.17940/endoskopi.410908

Abstract

Background and Aims: Perforations developing during colonoscopy are rare. The aim of this study was to evaluate patients diagnosed with iatrogenic colon perforation caused during colonoscopy. Materials and Methods: We retrospectively evaluated patients who had been diagnosed with iatrogenic colon perforation caused during colonoscopy at the Kafkas University Faculty of Medicine’s General Surgery Endoscopy Unit between January 2008 and December 2017. Demographic features, clinical findings, surgical intervention details, and follow-up data of the patients diagnosed with iatrogenic colon perforation during or after colonoscopy were recorded. Results: A total of 3,562 patients consisting of 1,712 males and 1,850 females had undergone colonoscopy at our colonoscopy unit. These procedures consisted of 2,561 total colonoscopies and 1,001 rectosigmoidoscopies. Polyp excision was performed in 300 and colon biopsy in 858 patients. Iatrogenic colon perforation developed in 8 patients in total, and the diagnosis was made during the procedure in 8 patients and 24 h later in 1 patient. Among those patients diagnosed during colonoscopy, primary colorrhaphy was performed in 5 patients, primary colography with intestinal resection anastomosis was performed in 1 patient, and the Hartmann procedure was performed in the remaining patients. The Hartmann procedure was also performed in the patient diagnosed with colon perforation 24 h after colonoscopy. Conclusion: Perforation can develop due to various predisposing conditions during colonoscopy. Primary repair is indicated in the early period and a stoma in the late period in these cases. Conservative treatment can also be used in experienced centers.

References

  • 1. Macrae FA, Tan K, Williams CB. Towards safer colonoscopy: a report on the complications of 5000 diagnostic or therapeutic colonoscopies. Gut 1983;24:376-83.
  • 2. Heath B, Rogers A, Taylor A, Lavergne J. Splenic rupture: an unusual complication of colonoscopy. Am J Gastroenterol 1994;89:449-50.
  • 3. Gündeş E, Çiyiltepe H, Aday U, et al. Emergency cases following elective colonoscopy: Iatrogenic colonic perforation. Turk J Surg 2017;33:248-52.
  • 4. Sagawa T, Kakizaki S, Iizuka H, et al. Analysis of colonoscopic perforations at a local clinic and a tertiary hospital. World J Gastroenterol 2012;18:4898-904.
  • 5. Church J. Complications of colonoscopy. Gastroenterol Clin North Am 2013;42:639-57.
  • 6.Tam MS, Abbas MA. Perforation following colorectal endoscopy: what happens beyond the endoscopy suite? Perm J 2013;17:17-21.
  • 7. Bas G, Okan İ, Erozgen F, et al. Management of iatrogenic colonic perforations related to colonoscopic examination. Turk J Colorectal Dis 2009;19:122-8.
  • 8. Gedebou TM, Wong RA, Rappaport WD, et al. Clinical presentation and management of iatrogenic colon perforations. Am J Surg 1996;172:454-8.
  • 9. Byeon JS. Colonic Perforation: Can we manage it endoscopically? Clin Endosc 2013;46:495-9.
  • 10. Hsieh YH, Lin HJ, Tseng KC. Limited water infusion decreases pain during minimally sedated colonoscopy. World J Gastroenterol 2011;17:2236-40.
  • 11.Taku K, Sano Y, Fu KI, Saito Y. Iatrogenic perforation at therapeutic colonoscopy: should the endoscopist attempt closure using endoclips or transfer immediately to surgery? Endoscopy 2006;38:428.
  • 12.Akin M, Ege B, Akin FE, et al. Colonic stricture following conservative treatment of a colonoscopic perforation. Endoscopy 2008;40(Suppl 2):E89.
  • 13. Campos S, Amaro P, Portela F, et al. Iatrogenic perforation coloscopy in a portuguese population: A study ıncluding in and out-of-hosipital procedures. GE Prot J Gastronterol 2016;23:183-90.

Kolonoskopiye bağlı iatrojenik kolon perforasyonu olgularımızın değerlendirilmesi

Year 2018, Volume: 26 Issue: 1, 27 - 29, 26.04.2018
https://doi.org/10.17940/endoskopi.410908

Abstract

Giriş ve Amaç: Kolonoskopik perforasyonlar nadir görülen komplikasyonlardır. Biz bu çalışmamızda kolonoskopi ile iatrojenik kolon perforasyonu tanısı konulan hastaların değerlendirilmesi amaçladık. Gereç ve Yöntem: Çalışmada Kafkas Üniversitesi Tıp Fakültesi Genel Cerrahi Endoskopi Ünitesinde Ocak 2008-Aralık 2017 tarihleri arasında kolonoskopi yapılan hastalar arasından iatrojenik kolon perforasyonu tanısı konulanlar retrospektif olarak değerlendirildi. Kolonoskopi sırasında ve sonrasında iatrojenik kolon perforasyonu belirlenen olguların demografik özelliklerinin yanı sıra klinik bulgular ve yapılan cerrahi girişimler takipleriyle birlikte kaydedildi. Bulgular: Endoskopi ünitemizde 1712’si erkek, 1850’si kadın olmak üzere toplam 3562 hastaya kolonoskopi yapıldığı belirlendi. Bunun 2561 tanesi total kolonoskopi, 1001 tanesi rektosigmoidoskopi idi. Bu olguların 300 tanesine polip eksizyonu, 858 tanesine kolon biyopsisi yapıldı. Toplam 8 hastada iatrojenik kolon perforasyonu meydana geldi. Hastaların 7 tanesine işlem esnasında, 1 tanesine ise 24 saat sonra kolon perforasyonu tanısı konuldu. Kolonoskopi sırasında kolon perforasyonu tespit edilen hastalardan 5 tanesine primer kolorafi, 1 tanesine primer kolografi ve ince barsak rezeksiyon anastomozu ve geriye kalan birine ise Hartmann prosedürü uygulandı. Konoskopi işleminden 24 saat sonra kolon perforasyonu saptanan diğer hastaya da Hartmann prosedürü uygulandı. Sonuç: Kolonoskopi esnasında çeşitli predispozan nedenlerle perforasyon görülebilir. Perforasyonu olan hastalara erken dönemde primer onarım tercih edilirken, geç dönemde stoma açılmalıdır. Deneyimli merkezlerde konservatif tedavi de yapılabilir.

References

  • 1. Macrae FA, Tan K, Williams CB. Towards safer colonoscopy: a report on the complications of 5000 diagnostic or therapeutic colonoscopies. Gut 1983;24:376-83.
  • 2. Heath B, Rogers A, Taylor A, Lavergne J. Splenic rupture: an unusual complication of colonoscopy. Am J Gastroenterol 1994;89:449-50.
  • 3. Gündeş E, Çiyiltepe H, Aday U, et al. Emergency cases following elective colonoscopy: Iatrogenic colonic perforation. Turk J Surg 2017;33:248-52.
  • 4. Sagawa T, Kakizaki S, Iizuka H, et al. Analysis of colonoscopic perforations at a local clinic and a tertiary hospital. World J Gastroenterol 2012;18:4898-904.
  • 5. Church J. Complications of colonoscopy. Gastroenterol Clin North Am 2013;42:639-57.
  • 6.Tam MS, Abbas MA. Perforation following colorectal endoscopy: what happens beyond the endoscopy suite? Perm J 2013;17:17-21.
  • 7. Bas G, Okan İ, Erozgen F, et al. Management of iatrogenic colonic perforations related to colonoscopic examination. Turk J Colorectal Dis 2009;19:122-8.
  • 8. Gedebou TM, Wong RA, Rappaport WD, et al. Clinical presentation and management of iatrogenic colon perforations. Am J Surg 1996;172:454-8.
  • 9. Byeon JS. Colonic Perforation: Can we manage it endoscopically? Clin Endosc 2013;46:495-9.
  • 10. Hsieh YH, Lin HJ, Tseng KC. Limited water infusion decreases pain during minimally sedated colonoscopy. World J Gastroenterol 2011;17:2236-40.
  • 11.Taku K, Sano Y, Fu KI, Saito Y. Iatrogenic perforation at therapeutic colonoscopy: should the endoscopist attempt closure using endoclips or transfer immediately to surgery? Endoscopy 2006;38:428.
  • 12.Akin M, Ege B, Akin FE, et al. Colonic stricture following conservative treatment of a colonoscopic perforation. Endoscopy 2008;40(Suppl 2):E89.
  • 13. Campos S, Amaro P, Portela F, et al. Iatrogenic perforation coloscopy in a portuguese population: A study ıncluding in and out-of-hosipital procedures. GE Prot J Gastronterol 2016;23:183-90.
There are 13 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Tülay Diken Allahverdi

Yusuf Günerhan This is me

Publication Date April 26, 2018
Published in Issue Year 2018 Volume: 26 Issue: 1

Cite

APA Diken Allahverdi, T., & Günerhan, Y. (2018). Kolonoskopiye bağlı iatrojenik kolon perforasyonu olgularımızın değerlendirilmesi. Endoskopi Gastrointestinal, 26(1), 27-29. https://doi.org/10.17940/endoskopi.410908
AMA Diken Allahverdi T, Günerhan Y. Kolonoskopiye bağlı iatrojenik kolon perforasyonu olgularımızın değerlendirilmesi. Endoskopi Gastrointestinal. April 2018;26(1):27-29. doi:10.17940/endoskopi.410908
Chicago Diken Allahverdi, Tülay, and Yusuf Günerhan. “Kolonoskopiye bağlı Iatrojenik Kolon Perforasyonu olgularımızın değerlendirilmesi”. Endoskopi Gastrointestinal 26, no. 1 (April 2018): 27-29. https://doi.org/10.17940/endoskopi.410908.
EndNote Diken Allahverdi T, Günerhan Y (April 1, 2018) Kolonoskopiye bağlı iatrojenik kolon perforasyonu olgularımızın değerlendirilmesi. Endoskopi Gastrointestinal 26 1 27–29.
IEEE T. Diken Allahverdi and Y. Günerhan, “Kolonoskopiye bağlı iatrojenik kolon perforasyonu olgularımızın değerlendirilmesi”, Endoskopi Gastrointestinal, vol. 26, no. 1, pp. 27–29, 2018, doi: 10.17940/endoskopi.410908.
ISNAD Diken Allahverdi, Tülay - Günerhan, Yusuf. “Kolonoskopiye bağlı Iatrojenik Kolon Perforasyonu olgularımızın değerlendirilmesi”. Endoskopi Gastrointestinal 26/1 (April 2018), 27-29. https://doi.org/10.17940/endoskopi.410908.
JAMA Diken Allahverdi T, Günerhan Y. Kolonoskopiye bağlı iatrojenik kolon perforasyonu olgularımızın değerlendirilmesi. Endoskopi Gastrointestinal. 2018;26:27–29.
MLA Diken Allahverdi, Tülay and Yusuf Günerhan. “Kolonoskopiye bağlı Iatrojenik Kolon Perforasyonu olgularımızın değerlendirilmesi”. Endoskopi Gastrointestinal, vol. 26, no. 1, 2018, pp. 27-29, doi:10.17940/endoskopi.410908.
Vancouver Diken Allahverdi T, Günerhan Y. Kolonoskopiye bağlı iatrojenik kolon perforasyonu olgularımızın değerlendirilmesi. Endoskopi Gastrointestinal. 2018;26(1):27-9.