Uzunlar Sena, Turaihi Alexander Haitham, Turaihi Hassan
University of South Dakota Sanford School of Medicine.
Department of Surgery, University of South Dakota Sanford School of Medicine.
S D Med. 2025 Aug;78(8):353-355.
Colonoscopic perforation is a severe but rare complication of lower gastrointestinal endoscopies, linked to high morbidity and mortality rates. Iatrogenic perforation during colonoscopy can lead to serious outcomes including extended hospital stays, need for surgical intervention, intra-abdominal sepsis, or death. While perforations have traditionally required surgical or interventional radiology management, use of over-the-scope clipping has offered the option of endoscopic management. Herein we report the case of a 79-year-old woman who presented with concern for colonic perforation after endoscopic polypectomy. Colonic perforation was detected at a follow up colonoscopy. Further investigation with CT revealed findings of perforation with pneumoperitoneum. Repeat colonoscopy was performed revealing the perforation in the distal colon. During the procedure, hemostatic over-the-scope clips were placed, and the defect was successfully closed. This paper aims to highlight the incidence of perforation during colonoscopy and to discuss the role endoscopic management in bowel perforation.
结肠镜穿孔是下消化道内镜检查中一种严重但罕见的并发症，与高发病率和死亡率相关。结肠镜检查期间的医源性穿孔可导致严重后果，包括延长住院时间、需要手术干预、腹腔内感染或死亡。虽然传统上穿孔需要手术或介入放射学处理，但使用套扎器提供了内镜处理的选择。在此，我们报告一例79岁女性病例，该患者在内镜下息肉切除术后出现结肠穿孔的担忧。在随访结肠镜检查中发现结肠穿孔。CT进一步检查显示有气腹的穿孔表现。再次进行结肠镜检查发现远端结肠穿孔。在手术过程中，放置了止血套扎器，缺损成功闭合。本文旨在强调结肠镜检查期间穿孔的发生率，并讨论内镜处理在肠穿孔中的作用。
