Prompt Management Is Most Important for Colonic Perforation After Colonoscopy
김현호, 계봉현, 김형진, 조현민,
소속 상세정보
김현호 ( Kim Hyun-Ho )
Catholic University College of Medicine St. Vincent’s Hospital Departments of Surgery
계봉현 ( Kye Bong-Hyeon )
Catholic University College of Medicine St. Vincent’s Hospital Departments of Surgery
김형진 ( Kim Hyung-Jin )
Catholic University College of Medicine St. Vincent’s Hospital Departments of Surgery
조현민 ( Cho Hyeon-Min )
Catholic University College of Medicine St. Vincent’s Hospital Departments of Surgery
KMID : 0356720140300050228
Abstract
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.
키워드
Intestinal perforation; Colonoscopy
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