Subcutaneous emphysema, pneumomediastinum and pneumoperitoneum after diagnostic colonoscopy for ulcerative colitis: a rare but possible complication in patients with multiple risk factors
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Colonoscopy is regarded as a safe procedure, but complications may occur. The most dreaded are perforation and massive bleeding of the colon. The incidence of perforation is low but, despite increased experience with the procedure, it remains unchanged over time and in a large population study ranges from 0.6 to 1 per 1.000 procedures, depending on the centre and the data source. Few studies have assessed risk factors for colonoscopy-related bleeding and perforation. Gatto et al. have reported that there was a significant trend in the incidence of perforation with increasing age, people aged 75 years or older having a fourfold risk as compared to those aged 65–69 years; same results were obtained by Levin et al. in a series of more than 16.000 colonoscopies. The risk for adverse events has been also associated with comorbidity: diabetes, stroke, cardiovascular disease, chronic obstructive pulmonary disease. Moreover, risk factors for the development of perforations are...