Diagnóstico y tratamiento de la perforación de colon durante la colonoscopia

background: colon perforation is an uncommon but feared complication of colonoscopy. the treatment is usually surgical but occasionally it does not require an operation. aim: to report our experience in the diagnosis and management of colon perforation after colonoscopy. material and methods: retrospective review of the database of 11,720 colonoscopies. the medical records of those patients that had a perforation were reviewed. results: twelve perforations in patients aged 26 to 92 years (six women), were identified with a global perforation rate of 0.1%. five occurred during diagnostic and seven during therapeutic procedures. all perforations were confirmed by a plain x ray or ct scan of the abdomen. four patients, without signs of initial diffuse peritoneal irritation, were medically treated. one of these, finally required surgery. among operated patients, a primary suture was done in five, a primary excision without colostomy in three and a hartmann procedure due to a severe peritoneal contamination in one. no patient died. conclusions: there is a higher risk of colon perforation during therapeutic colonoscopies. selected cases may be safely treated without surgery