[Colonic perforations complicating colonoscopy. Apropos of 15 consecutive cases observed over 16 years]. / Les perforations coliques compliquant la coloscopie. A propos de 15 cas consécutifs observés en 16 ans.

ABSTRACT

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.