Abstract
This is a report on 126 prospectively registered and controlled complications in 29,695 consecutive endoscopic procedures of the lower gastrointestinal tract. The overall complication rate is 0.4%. All endoscopic procedures were performed in our institution; no referrals “from other hospitals” are included. The therapy and prognosis of occurring complications are described. Especially after therapeutic endoscopy—above all, after polypectomy—the complication rate of 0.83% is not negligible. A serious aspect is the average interval of 30 h from endoscopically caused complication to the onset of symptoms. Bleeding could be managed conservatively in 76% of cases. Nevertheless perforation and transmural burn injuries required surgical intervention in 78% of cases. The authors conclude that in the case of transmural burn an attempt at “active conservative treatment” is justified if the patient is under close surgical control, if the symptoms improve, and if there is a possibility of immediate surgery.
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References
Brynitz S, Kjaergard H, Struckmann J (1986) Perforations from colonoscopy during diagnosis and treatment of polyps. Ann Chir Gynaecol 75: 142–145
Carpio G, Albu E, Gumbs MA, Gerst PH (1989) Management of colonic perforation after colonoscopy. Report of three cases. Dis Colon Rectum 32: 624–626
Christie JP, Marrazzo J (1991) “Mini-perforation” of the colon—not all postpolypectomy perforations require laparotomy. Dis Colon Rectum 34: 132–135
Dubas F, Rohner A (1985) Perforations colo-rectales iatrogenes. Helv Chir Acta 52: 681–686
Fasano JJ (1985) Chirurgie des complications des explorations paraclinique colorectacles. Ann Gastroenterol Hepatol Paris 21: 371–375
Fassoulaki A, Mihas A (1987) Changes in arterial blood gases associated with gastrointestinal endoscopies. Acta Anaesthesiol Belg 38: 127–131
Friedrichs D (1983) Diagnose und Theapie der endoskopischen Dickdarmperforation. Med Welt 34: 75–76
Hall C, Dorricott NJ, Donovan IA, Neoptolemos JP (1991) Colon perforation during colonoscopy: surgical versus conservative management. Br J Surg 78: 542–544
Hart R, Classen M (1990) Complications of diagnostic gastrointestinal endoscopy. Endoscopy 22: 229–233
Hesterberg R, Stahlknecht CD, Sattler J, Bojahr U (1987) Endoskopische Abtragung von kolorektalen Polypen. Dtsch Med Wochenschr 112: 210–213
Höllerl G, Stenzel B, Stadler H (1980) Prophylaxe und Therapie der Dickdarmperforation bei der diagnostischen Fiberskopie. Z Gastroenterol 18: 376–378
Isbister W (1986) Colorectal polyps: an endoscopic experience. Aust N Z J Surg 56: 717–722
Macrae FA, Tan KG, Williams CG (1982) Towards safer colonoscopy: a report on the complications of 5000 diagnostic or therapeutic colonoscopies. Gut 24: 376–383
Moser B (1987) Koloskopie im hohen Lebensalter: Herzrhythmusstörungen. Leber Magen Darm 17: 305–312
Nivatvongs S (1988) Complications in colonoscopic polypectomy: Lessons to learn from an experience with 1576 polyps. Am Surg 54: 61–63
Smith LE (1976) Fiberoptic colonoscopy: complications of colonoscopy and polypectomy. Dis Colon Rectum 19: 407–412
Soon JCC, Shang NSS, Goh PMY, Rauff A (1990) Perforation of the large bowel during colonoscopy in Singapore. Am Surg 56: 285–288
Vincent M, Smith LE (1983) Management of perforation due to colonoscopy. Dis Colon Rectum 26: 61–63
Weidemann H, Schulz C, Lemmers HP, Neuhaus P (1992) Iatrogene kolorektale Perforationen bei transanalen diagnostischen und therapeutischen Maßnahmen. Aktuell Chir 27: 230–234
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Jentschura, D., Raute, M., Winter, J. et al. Complications in endoscopy of the lower gastrointestinal tract. Surg Endosc 8, 672–676 (1994). https://doi.org/10.1007/BF00678564
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DOI: https://doi.org/10.1007/BF00678564