Skip to main content
Log in

Colonoscopic impaction in left colon strictures resulting in right colon pneumatic perforation

  • Original Articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Summary

Colonic perforation during flexible colonoscopy is a rare but recognized complication. We reviewed 4,593 colonoscopies performed from 1984 to 1989. The perforation rate for diagnostic colonoscopy was 0.17% (6/3,538) and for therapeutic colonoscopy it was 2% (21/1,055). Four perforations of the right colon occurred at a site proximal to the level of the impacted colonoscope. The lesions being evaluated were obstructive in nature: two diverticular strictures (sigmoid colon), one ischemic stricture (descending colon), and one annular carcinoma (descending colon). The four perforations occurred in the right colon and manifested as distension with pneumoperitoneum or retroperitoneal emphysema. Operative management included total abdominal colectomy in two patients (ileoproctostomy in one and ileostomy in one) and right colectomy in two. Outcome was favorable in all cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Adair HM, Hishon S (1981) The management of colonoscopic and sigmoidoscopic perforations of the large bowel. Br J Surg 68:415–416

    PubMed  CAS  Google Scholar 

  2. Brynitz S, Kjaegard H, Stuckmann J (1986) Perforations from colonoscopy during diagnosis and treatment of polyps. Ann Chirg Gynaecol 75:142–145

    CAS  Google Scholar 

  3. Burt CA (1931) Pneumatic rupture of the intestinal canal with experimental data showing the mechanism of perforation and the pressure required. Arch Surg 22:875–902

    Google Scholar 

  4. Carpio G, Albu E, Gumbs MA, et al (1989) Management of colonic perforation after colonoscopy. Report of three cases. Dis Colon Rectum 32:624–662

    PubMed  CAS  Google Scholar 

  5. Fruhmorgen P, Demling L (1979) Complications of diagnostic and therapeutic colonoscopy in the Federal Republic of Germany. Results of an inquiry. Endoscopy 11:146–150

    Article  PubMed  CAS  Google Scholar 

  6. Ghazi A, Grossman M (1982) Complications of colonoscopy and polypectomy. Surg Clin North Am 62:889–896

    PubMed  CAS  Google Scholar 

  7. Kaven H, Sinicrope F, Esker A (1992) Management of perforation of the colon at colonoscopy. Am J Gastro 87:161–167

    Google Scholar 

  8. Kozarek RA, Earnest DL, Silverstein ME, Smith RG (1980) Airpressure-induced colon injury during diagnostic colonoscopy. Gastroenterology 78:7–14

    PubMed  CAS  Google Scholar 

  9. Livstone EM, Cohen GM, Troncale EJ, et al. (1974) Diastalic serosal lacerations: an unrecognized complication of colonoscopy. Gastroenterology 67:1245–1247

    PubMed  CAS  Google Scholar 

  10. Livstone EM, Kerstein MD (1976) Serosal tears following colonoscopy. Arch Surg 111:88

    PubMed  CAS  Google Scholar 

  11. Macrae FA, Tan KG, Williams CB (1983) Towards safer colonoscopy: a report on the complications of 5000 diagnostic therapeutic colonoscopies. Gut 24:376–383

    PubMed  CAS  Google Scholar 

  12. Nelson RI, Abcarian H, Prasad ML (1982) Iatrogenic perforation of the colon and rectum. Dis Colon Rectum 25:305–308

    PubMed  CAS  Google Scholar 

  13. Quenu E (1882) Des ruptures spontanées du rectum. Rev Chir 2:173–188

    Google Scholar 

  14. Shamir M, Schuman BM (1980) Complications of fiberoptic endoscopy. Gastrointest Endosc 26:86–91

    Google Scholar 

  15. Smith LE, Nivatvongs S (1975) Complications in colonoscopy. Dis Colon Rectum 18:214

    PubMed  CAS  Google Scholar 

  16. Soon JCC, Shang NS, Goh PMY, Rauff A (1990) Perforations of the large bowel during colonoscopy in Singapore. Am Surg 56:285–288

    PubMed  CAS  Google Scholar 

  17. Stone GW (1904) Rupture of the bowel caused by compressed air. Lancet 2:216

    Article  Google Scholar 

  18. Vincent M, Smith LE (1983) Management of perforation due to colonoscopy. Dis Colon Rectum 26:61–63

    PubMed  CAS  Google Scholar 

  19. Williams C, Teague R (1973) Colonoscopy. Gut 14:990–1003

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Luchette, F.A., Doerr, R.J., Kelly, K. et al. Colonoscopic impaction in left colon strictures resulting in right colon pneumatic perforation. Surg Endosc 6, 273–276 (1992). https://doi.org/10.1007/BF02498858

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02498858

Key words

Navigation