Delayed perforation of the cecum after diagnostic biopsy.

Colonoscopy is an important diagnostic study in monitoring patients with chronic ulcerative colitis for carcinoma and dysplasia (precancer). A 76-year-old woman with chronic ulcerative colitis of 13 years' duration underwent colonoscopy. Biopsies were obtained at 10-cm intervals throughout the entire colon. A delayed perforation of the cecum was diagnosed 48 h after the diagnostic study. This necessitated a subtotal colectomy. It is suggested that in such patients cecal biopsies should be obtained with extreme caution because of the relative increase in intraluminal pressures and the relative thinness of the cecal wall.