Colon perforation during colonoscopy: surgical versus conservative management

Br J Surg. 1991 May;78(5):542-4. doi: 10.1002/bjs.1800780509.


A survey of endoscopy units in the West Midlands, UK, was undertaken to ascertain the management of colonic perforation during colonoscopy. Fifteen perforations were reported from a total of 17,500 colonoscopies performed in 14 units (a rate of 0.09 per cent). In seven patients the diagnosis was suspected or diagnosed immediately and in the remaining eight 2-72 h later. Four patients with associated pathology (carcinoma, Crohn's disease, ulcerative colitis and a polyp) had resection and primary anastomosis. Seven patients had a simple oversew, four of these having had a delayed diagnosis. In four cases the site of perforation was not identified, but only one patient had conservative treatment. Three patients had drainage and a defunctioning colostomy. There was no significant morbidity following treatment. It is recommended that patients who have had a good bowel preparation should be treated conservatively unless there is a large perforation or an underlying carcinoma.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Colonic Diseases / etiology*
  • Colonic Diseases / surgery
  • Colonic Diseases / therapy
  • Colonoscopy / adverse effects*
  • Colostomy
  • Drainage
  • Female
  • Humans
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / surgery
  • Intestinal Perforation / therapy
  • Intraoperative Complications / therapy
  • Male
  • Middle Aged