The Indications for Nonsurgical Management in Patients with Colorectal Perforation after Colonoscopy
| Autor: | In Kyu Lee, Yoon Suk Lee, Seung Bong Choi, Dae Youn Won, Hun Jung, Seung Taek Oh, Dae Young Cheung |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Abdominal pain Colon medicine.medical_treatment Perforation (oil well) Colonoscopy Colonic Diseases medicine Humans In patient Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry General surgery Disease Management Sigmoid colon General Medicine Middle Aged Nonsurgical treatment Surgery medicine.anatomical_structure Intestinal Perforation Therapeutic endoscopy Bowel preparation Female medicine.symptom business Follow-Up Studies |
| Zdroj: | The American Surgeon. 78:550-554 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313481207800536 |
| Popis: | Recently, the risk of colonic perforation has been increasing with the increased frequency of advanced therapeutic endoscopy. However, guidelines for the management of colon perforations after colonoscopy have not been established. This study aimed to evaluate the indications for nonsurgical management. This study was conducted as a case–control study with 22 patients who were managed for colorectal perforations after colonoscopy from June 2004 to July 2009. Colonoscopy was performed in 12 patients (54.4%) for diagnostic purposes and 10 (45.5%) for therapeutic reasons. The most common site of perforation was the sigmoid colon (77.3%). Five patients underwent nonsurgical treatment, and 17 patients received surgical treatment. The duration of hospital stay did not differ significantly between the two groups. Abdominal pain and fever were significantly more commonly encountered in the surgical management group ( P = 0.043 and 0.011, respectively). All of the patients who were suitable for nonsurgical treatment were diagnosed within 24 hours and received bowel preparation before the colonoscopy. The nonsurgical treatment of colonic perforation after colonoscopy could be feasible in afebrile patients with less severe abdominal pain. Moreover, cases that were diagnosed within 24 hours and received bowel preparation before colonoscopy were associated with better outcomes. |
| Databáze: | OpenAIRE |
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