[Colonic perforations complicating colonoscopy. Apropos of 15 consecutive cases observed over 16 years].

OBJECTIVES

Our study was undertaken to better assess the circumstances of perforation during colonoscopy.

METHODS

All cases observed in our department between 1978 and 1994 were computer recorded. During this period, 5,822 colonoscopies were performed, including 872 with at least one polypectomy.

RESULTS

All perforations occurred during colonoscopies performed under anaesthesia (n = 3,373 vs 2,449 without anaesthesia). There were a total of 15 observations of colonic perforations, 1 perforation in 388 colonoscopies. Ten perforations occurred during diagnostic colonoscopies (0.20%), 5 after polypectomy (0.57%). Eight of 10 perforations complicating diagnostic colonoscopies occurred below an impassable stricture. Two patients died from this complication (0.03% of all colonoscopies).

CONCLUSIONS

Our study suggests that endoscopic exploration of colonic stricture, in addition to anaesthesia, increases the risk of colonic perforation.