Onset and clinical course of bleeding and perforation after outpatient colonoscopy: a population-based study

Gastrointest Endosc. 2011 Mar;73(3):520-3. doi: 10.1016/j.gie.2010.10.034. Epub 2010 Dec 31.


Background: Endoscopists are advised to measure and report their rates of colonoscopy-associated perforation and bleeding. However, evidence from population-based studies is lacking on the time period over which monitoring is needed to detect these adverse events.

Objective: To determine the time course of perforation or bleeding requiring hospital admission within 30 days after outpatient colonoscopy.

Design: Population-based cohort study.

Setting: Ontario, Canada.

Patients and interventions: Men and women, 50 to 75 years old who underwent an outpatient colonoscopy during the period from April 1, 2002 to March 31, 2003.

Main outcome measurements: Hospitalization for colonoscopy-related perforation or bleeding within 30 days after the procedure.

Results: We identified 67,632 patients who had an outpatient colonoscopy, of whom 37 were admitted for hospitalization with perforation and 83 with bleeding within 30 days after the procedure. For those with a perforation, 34 of 37 (92%) were admitted within 2 days and all within 5 days. For those with bleeding, 30 of 83 (36%) were admitted within 2 days and 80 of 83 (96%) within 14 days.

Limitations: Lack of information on medication use.

Conclusions: After outpatient colonoscopy, use of a 14-day time period for reporting would capture all perforations and the majority (96%) of bleeds requiring hospital admission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Transfusion
  • Cohort Studies
  • Colonoscopy / adverse effects*
  • Female
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / therapy
  • Hospitalization / statistics & numerical data*
  • Humans
  • Intestinal Perforation / epidemiology
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / surgery
  • Length of Stay
  • Male
  • Middle Aged
  • Ontario / epidemiology
  • Outpatients / statistics & numerical data*
  • Time Factors