Case Report: Rectal perforation during CT colonography (original) (raw)
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Journal of medical screening, 2010
Computed tomographic (CT) colonography (or 'virtual' colonoscopy) has become an increasingly popular tool for colorectal cancer screening. Colonic perforation, an uncommon complication, is a risk that has not been widely reported. A systematic review of the literature was undertaken to identify all reported risk factors for colonic perforation following CT colonography. In addition, a retrospective multicentre study was undertaken, evaluating all CT colonographies in 10 major metropolitan tertiary referral centres. All colonic perforations were assessed for risk factors. A range of 'patient'-related and 'procedure'-related risk factors were identified in the literature. Among 3458 CT colonographies, there were two cases of colonic perforation contributing to an incidence of perforation of 0.06%. There was no statistical correlation between the incidence of perforation and institutional experience (P = 0.66). Risk factors common to both cases and the literatur...
CASE REPORT Conservative Management of Colonoscopic Perforation: A Case Report
2017
Colonoscopy is widely used for the diagnosis, treatment and a follow up of colorectal diseases. Perforation of the large bowel during elective colonoscopy is rare but serious life threatening complication. We report a 51-year-old woman who experienced recto sigmoid perforation during diagnostic colonoscopy. During 8 days of total hospitalization, she spent 3 days in ICU with gastrointestinal rest. The patient was hydrated and took intravenous antibiotics. In take-output and temperature were closely monitored. Serial abdominal examinations were performed to rule out peritonitis. After transferring to surgery ward in the day 4, liquid diet started slowly, and she was ambulated. At the day 8, she was discharged with the good clinical condition. Conservative management of the patients with early diagnosis of perforation and no signs and symptoms of peritonitis or sepsis could be the modality of choice.
Conservative Management of Colonoscopic Perforation: A Case Report
Acta medica Iranica, 2017
Colonoscopy is widely used for the diagnosis, treatment and a follow up of colorectal diseases. Perforation of the large bowel during elective colonoscopy is rare but serious life threatening complication. We report a 51-year-old woman who experienced recto sigmoid perforation during diagnostic colonoscopy. During 8 days of total hospitalization, she spent 3 days in ICU with gastrointestinal rest. The patient was hydrated and took intravenous antibiotics. In take-output and temperature were closely monitored. Serial abdominal examinations were performed to rule out peritonitis. After transferring to surgery ward in the day 4, liquid diet started slowly, and she was ambulated. At the day 8, she was discharged with the good clinical condition. Conservative management of the patients with early diagnosis of perforation and no signs and symptoms of peritonitis or sepsis could be the modality of choice.
Colonoscopic perforations: Single center experience and review of the literature
Turkish journal of surgery, 2017
Iatrogenic colonic perforation is a well-known complication that can increase mortality and morbidity in patients undergoing colonoscopy. Closer follow-up and a well-planned treatment strategy are required when perforation arises as a complication. The aims of this study are to (1) report our experience with a large colonoscopy series; (2) evaluate the underlying mechanisms of iatrogenic colonic perforation; (3) discuss the ideal period between onset and treatment; and (4) review the current literature regarding the management of iatrogenic colonic perforations. Patients who underwent colonoscopy between January 2005 and May 2015 at a single center were reviewed retrospectively. Procedures during which colonic perforations occurred were documented and analyzed. Between January 2005 and May 2015, 31,655 patients underwent colonoscopy and 5,214 patients underwent recto-sigmoidoscopy at our center. Thirteen of these procedures were associated with perforation. The perforation rate was ...
Perforation rate in CT colonography: a systematic review of the literature and meta-analysis
European Radiology, 2014
Purpose The primary aim was to assess the perforation rate of CTC; the secondary aim was to identify potential clinical/ technical predictors of this complication. Methods Methods for analysis were based on PRISMA (preferred reporting items for systematic reviews and metaanalyses). From the selected studies, the rate of CTC perforation and patient/technical characteristics potentially associated with this event were extracted. Forest plots showing individual and pooled estimates of the perforation rate were obtained for all analyses. I 2 was used to evaluate heterogeneity between studies.
Management of iatrogenic perforations during colonoscopy
Journal of Turkish Association of Colorectal Surgeons, 2011
Amaç: Kolon perforasyonu, rutin ya da tedavi amaçl› yap›lan kolonoskopinin en korkulan komplikasyonlar›ndan biri haline gelmifltir. Bu komplikasyonun tedavisi takip s›ras›nda hastan›n durumuna ba¤l›d›r. Tedavi aç›k ya da laparoskopik acil cerrahi olabilece¤i gibi, konservatif de olabilir. Kolonoskopi s›ras›nda rektal retrofleksiyonun yaralanmas›n da genellikle perforasyon riski düflüktür ve yine bu hastalar›n tedavisi operasyon gerektirmeyebilir. Biz bu yaz›da, elektif kolonoskopi s›ras›nda meydana gelen kolon perforasyonu geliflen hastalar›m›z› ve tedavi yöntemlerini sunduk. Hastalar ve Yöntemler: Aral›k 2005 ile Aral›k 2010 aras›nda kolonoskopi yap›lm›fl hastalardan perforasyon geliflen hastalara ait bilgiler retrospektif olarak de¤erlendirildi. Bulgular: Yukar›daki tarihler aras›nda 5825 hastaya kolonoskopi yap›lm›fl, 3 hastada perforasyon ABSTRACT Purpose: Perforation of colon has become one of the most fearsome complications of routine or therapeutic colonoscopy. The treatment is immediate surgery via open or laparoscopic technique. However, rectal retroflexion injury during colonoscopy is associated with a low rate of perforation and the cases can be managed non-operatively. We report our series of colonic perforation due to elective colonoscopy and management of the cases. Patients and Methods: Iatrogenic perforation of the colon due to colonoscopy were collected retrospectively at our unit between dates December 2005-December 2010. Results: Of the 5825 colonoscopies performed between the above mentioned dates, a perforation rate of 0.051% was observed and three perforations occurred. Conclusion: Each treatment has to be individualized
Diseases of The Colon & Rectum, 2007
We report a case of colonic perforation in CT colonography, which was observed in a sigmoid colon segment contained within an inguinal hernia. At surgery, apart from the perforation, a normal large-bowel wall was found. Although rare, perforation may occur in patients with normal bowel wall, possibly resulting from a mechanical strain caused by gaseous overdistention. Radiologists performing the procedure must be aware of this possibility.
Abdominal CT findings in nontraumatic colorectal perforation
European Journal of Radiology, 2008
Colorectal perforation is an emergent medical condition in which the diagnosis and the etiology are often established on CT, the common imaging modality used for evaluating the acute abdomen. The cardinal, direct CT features suggesting perforation are extraluminal air and enteric contrast, added by secondary signs of bowel pathology, such as focal bowel wall thickening and bowel wall defect. This pictorial review will illustrate the CT findings of colorectal perforation caused by various clinical entities.
Endoscopic Perforation of The Colon: Lessons From A 10-Year Study
American Journal of Gastroenterology, 2000
OBJECTIVES: To assess the incidence, clinical features, and management of endoscopic colon perforations in a large number of patients at a major medical teaching center. METHODS: A retrospective review of medical records of all patients with colon perforations from endoscopy over a 10-yr period. RESULTS: A total of 10,486 colonoscopies were performed over a 10-yr period. There were 20 (0.19%) perforations and two (0.019%) deaths related to colonoscopy and two perforations with no deaths in 49,501 sigmoidoscopies (0.004%). The majority of perforations (65%) occurred in the sigmoid colon. The mean age of the patients was 72 yr (range, 48-87 yr). Multivariate analysis using gender and age showed that female gender was an independent predictor of a higher risk of perforation (p Ͻ 0.05). Electrocautery injury (36%) and mechanical injury (32%) from the tip and shaft of the endoscope were the major causes for perforation. Most patients (91%) presented within 48 h of endoscopy. Nine patients (47%) required a surgical resection with primary anastomosis; seven (37%) required a simple closure. The average hospital length of stay was 7.7 Ϯ 2.8 days. Although trainee endoscopists were involved in only 20% of the colonoscopies performed, eight (40%) perforations occurred while the training fellow was involved in the case. However, this increased risk of perforation with a training fellow was not statistically significant (p ϭ 0.625). CONCLUSIONS: Colonoscopy can result in significant morbidity and carries a small risk of death. Sigmoidoscopy has lower risk. The following situations may represent increased risk to colonoscopy patients: unusual difficulty in traversing the sigmoid colon; difficult examinations in female patients, and difficult examinations performed by trainee physicians.