Incidence and management of colonoscopic perforations: 8 years' experience

瞄准：与诊断、治疗学的 colonoscopies 考察一个主要医药教学中心的经验并且估计相关结肠的穿孔的发生和管理。方法：所有 colonoscopies 在 1994 年 1 月之间表现了， 2001 年 12 月被学习。病人， colonoscopic 报告和过程相关的复杂并发症上的数据从部的计算机化的数据库被收集。有柱子的病人的医药记录程序的结肠的穿孔被考察。结果：120067 colonoscopies 的一个总数在学习的 8 年期间被执行。七个 colonoscopic 穿孔(4 女性， 3 男性) 被诊断(0.058%) 。五发生了在期间诊断并且二在治疗学的结肠镜检查期间。六在结肠镜检查以后被怀疑在期间或立即。除了都，一有弥漫的温柔的符号并且经历了立即的操作，主要修理在 4 个病人做。没有死亡被报导。结论：穿孔率在结肠镜检查期间是低的。不过，它是严肃的复杂并发症和它的早识别，治疗是必要的优化结果。在有早起作用的弥漫的腹膜炎的病人，干预使主要修理成为一种安全选择。

AIM： To review the experience of a major medical teaching center with diagnostic and therapeutic colonoscopies and to assess the incidence and management of related colonic perforations. METHODS： All colonoscopies performed between January 1994 and December 2001 were studied. Data on patients, colonoscopic reports and procedure-related complications were collected from the departmental computerized database. The medical records of the patients with post procedural colonic perforation were reviewed. RESULTS： A total of 12 067 colonoscopies were performed during the 8 years of the study. Seven colonoscopic perforations （4 females, 3 males） were diagnosed （0.058%）. Five occurred during diagnostic and two during therapeutic colonoscopy. Six were suspected during or immediately after colonoscopy. All except one had signs of diffuse tenderness and underwent immediate operation with primary repair done in 4 patients. No deaths were reported. CONCLUSION： Perforation rate during colonoscopy is low. Nevertheless, it is a serious complication and its early recognition and treatment are essential to optimize outcome. In patients with diffuse peritonitis early operative intervention makes primary repair a safe option.