Fasano J J
Ann Gastroenterol Hepatol (Paris). 1985 Dec;21(6):371-5.
Colo-rectal perforations during barium enema are exceptional, but very serious. They give rise to a retro- or intra-peritoneal septic barioma. Despite its emergency treatment, the peritonitis remains very severe (50% mortality) and peritoneal toilet is difficult. Peri-visceral complications are also possible. Perforations during diagnostic colonoscopy are less serious, as they occur in a prepared colon. When operated immediately, the mortality is less than 20%. The greatest risk consists of overlooking the initial accident and only reviewing the patient at a late stage. In this case, the mortality is similar to that of the radiological perforations. Perforations during polypectomy are generally small or simple fissures and are less often surgical. Severe haemorrhages requiring a surgical operation are exceptional. All of these complications tend to disappear when certain technical rules are respected and with increasing operator experience.
钡剂灌肠期间的结直肠穿孔虽罕见,但后果严重。它们会引发腹膜后或腹膜内感染性钡瘤。尽管进行了紧急治疗,腹膜炎仍很严重(死亡率达50%),且难以进行腹膜清理。也可能出现脏器周围并发症。诊断性结肠镜检查期间的穿孔不太严重,因为穿孔发生在已准备好的结肠。若立即手术,死亡率低于20%。最大的风险在于忽视最初的意外情况,仅在晚期才对患者进行复查。在这种情况下,死亡率与放射学穿孔的死亡率相似。息肉切除术中的穿孔通常较小或为简单的裂隙,手术治疗的情况较少。需要手术的严重出血情况罕见。当遵循某些技术规则且术者经验增加时,所有这些并发症往往会消失。